盐酸戊乙奎醚在小儿氯胺酮麻醉前应用的临床观察  

Clinical Observation of Penehyclidine Hydrochloride in Pediatric Anesthesia with Ketamine before the Application

作　　者：房建[1] 

机构地区：[1]安徽省淮北市妇幼保健院麻醉科,235000

出　　处：《中华全科医学》2012年第4期538-539,共2页Chinese Journal of General Practice

摘　　要：目的观察盐酸戊乙奎醚在小儿氯胺酮麻醉前应用的临床效果。方法选择ASAⅠ～Ⅱ级,择期行外科手术的小儿患者60例,随机分为A、B两组,各30例,A组使用盐酸戊乙奎醚,B组使用阿托品,分别予以0.01 mg/kg术前30 min肌注,观察并记录给药前,给药后30 min平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)和体温(T)等变化,以及术毕清醒后,吸尽口腔和鼻腔的分泌物并计量(ml),用VAS评分法测定用药前即刻、给药后30 min口干的程度。结果在给药前两组患者MAP、SPO2、HR、T差异无显著变化,口干的数量差异亦无统计学意义。给药后30 min,A组MAP、HR上升不明显,B组MAP、HR明显升高(P<0.05),B组体温升高明显(P<0.05),A组主诉口干的数量明显多于B组(P<0.05),术毕B组分泌物的量明显多于A组(P<0.05),组间有差异有统计学意义(P<0.05)。结论新型选择性抗胆碱药盐酸戊乙奎醚对M受体具有高度选择性,作为小儿氯胺酮麻醉前用药可明显减少唾液分泌,不影响患儿的心率、血压及体温,无明显不良反应,是一种更适合患儿的术前抗胆碱药。Objective To observe the clinical effect of penehyclidine hydrochloride in pediatric anesthesia before the applica tion of ketamine. Methods 60 cases of ASA I IT , undergoing surgical operation were randomly divided into two groups,30 cases in each group. Group A with penehyclidine hydrochloride, group B with atropine, respectively O. O1 mg/kg for 30 minutes before injection. Mean arterial pressure（MAP） ,heart rate（HR） ,oxygen saturation（ SPO2 ） and body temperature（T） and other changes, as well as postoperative awake after, suction, oral and nasal secretions and measurement（ml） were observed and recor ded before drug administration, and 30 min after drug delivery. VAS score method was used to determine dry degree immediately and 30 min after the administration. Results In the administration of patients in two groups before MAP, SPO2, HR,T had no significant difference in the number of differences, and there was no significant meaning about dry mouth. After administration of 30 min, MAP, HR A group increased obviously, group B MAP, HR obviously increased （ P 〈 O. 05 ）, B group temperature in creased significantly （ P 〈 0.05 ）, A group complained of dry volume was significantly more than those in group B （ P 〈 O. 05 ）. The secretion amount were more than those in group A （ P 〈 O. 05 ）. There was a significant difference between groups （ P 〈 O. 05 ）. Conclusion Novel selective anticholinergic medication of penehyclidine hydrochloride on M receptor was highly selective, as pe diatric ketamine preanesthetic medication can obviously reduce the secretion of saliva, did not affect the heart rate, blood pressure and body temperature of children, with no significant adverse reactions, which was a more suitable for children with ~mticholin ergic agent.

关 键 词：小儿氯胺酮麻醉 术前药 盐酸戊乙奎醚 阿托品 

分 类 号：R614.24[医药卫生—麻醉学]