格隆溴铵和长托宁对斜视矫正术患儿术中眼心反射和术后恶心呕吐的影响  

Effects of glycopyrrolate and penehyclidine hydrochloride on intraoperative oculocardiac reflex and postoperative nausea and vomiting in children undergoing strabismus surgery

作　　者：汤西玲 侯雅欣 沈亚萍 吴俊鹤 孙振涛[1] Tang Xiling;Hou Yaxin;Shen Yaping;Wu Junhe;Sun Zhentao(Department of Anesthesiology,Pain and Perioperative Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450052

出　　处：《河南外科学杂志》2024年第4期22-25,共4页Henan Journal of Surgery

基　　金：河南省科技攻关计划(222102310640);河南省医学科技攻关计划软科学项目(RKX202202026)。

摘　　要：目的评价格隆溴铵和长托宁对斜视矫正术患儿术中眼心反射和术后恶心呕吐的影响。方法拟在全麻下行斜视矫正术患儿87例,年龄3~15岁,性别不限,ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为格隆溴铵组(G组,42例)和长托宁组(P组,45例)。麻醉诱导前5 min G组静注格隆溴铵5μg/kg,P组静注长托宁0.01 mg/kg。记录给药前(T_(0))及给药后10 min(T_(1))、20 min(T_(2))的SBP、SpO_(2)和HR。统计术中眼心反射(OCR)、术后24 h恶心呕吐(PONV),及其他不良反应发生率。结果2组患儿HR组间、时间差异有统计学意义(P<0.05),时间及组别交互差异明显(P<0.05)。与P组比较,G组患儿T_(1)、T_(2)时的HR均较高;P组患儿T_(1)、T_(2)时的SBP较T_(0)时明显降低。差异均有统计学意义(P<0.05)。G组患儿术中OCR的总发生率和需阿托品补救的发生率均低于P组,差异有统计学意义(P<0.05);2组患儿术中的PONV发生率差异无统计学意义(P>0.05)。G组患儿的其他不良反应发生率、差异无统计学意义(P>0.05)。结论与长托宁比较,格隆溴铵应用于小儿斜视矫正术,有利于维持术中血流动力学的平稳,有效预防术中发生眼心反射,且不会增加术后不良反应的发生率。Objective To evaluate the effects of glycopyrrolate and penehyclidine hydrochloride on intraoperative oculocardiac reflex and postoperative nausea and vomiting in children undergoing strabismus surgery.Methods Eighty-seven children aged 3~15 years,regardless of sex,ASA physical statusⅠorⅡ,were randomly devided into two groups using random number table method:glycopyrrolate group(group G,n=42)and penehyclidine hydrochloride group(group P,n=45).Five minutes before induction of anesthesia,group G was injected 5μg/kg of glycopyrrolate and group P was injected 0.01mg/kg of penehyclidine hydrochloride.The SBP,SpO_(2),and HR in both groups were observed and recorded before administration(T_(0)),10 minutes after administration(T_(1)),and 20 minutes after administration(T_(2)).The incidence of oculocardiac reflex,nausea and vomiting 24 hours after surgery,and operative adverse events were calculated.Results There were significant differences in HR between groups and time(P<0.05),and significant differences in time and interaction between groups(P<0.05).Compared with group P,the HR at T_(1)and T_(2)in group G was higher,and the SBP at T_(1)and T_(2)in group P was significantly lower than that at T_(0),the differences were statistically significant(P<0.05).The incidence of oculocardiac reflex and the demand rate of atropine in patients with oculocardiac reflex in group G were significantly lower than those in group P(P<0.05).There were no significant differences in the incidence of nausea and vomiting 24 hours after surgery and other adverse events between the two groups(P>0.05).Conclusion Compared with penehyclidine hydrochloride,the application of glycopyrrolate in pediatric strabismus surgery can maintain the stability of intraoperative hemodynamics,which is effective to prevent the incidence of oculocardiac reflex,and does not increase the occurrence of adverse events.

关 键 词：格隆溴铵 长托宁 斜视矫正术 术中眼心反射 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]