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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 before anesthesia in children with ketamine. Methods Sixty children with ASA Ⅰ ~ Ⅱ were enrolled in this study. They were randomly divided into A and B groups, 30 cases in each group. A group used penehyclidine hydrochloride, and B group used atropine, respectively, and received 0.01 mg / kg The changes of mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO2) and body temperature (T) were observed before and 30 min after administration by intramuscular injection 30 min before operation, After the mouth and nasal secretions were exhausted and measured (ml), the degree of dry mouth was measured immediately before administration and 30 min after administration by the VAS score method. Results There was no significant difference in MAP, SPO2, HR, T between the two groups before administration, and there was no significant difference in the number of dry mouth. At 30 min after administration, the MAP and HR did not increase significantly in group A, while the MAP and HR in group B were significantly increased (P <0.05). The body temperature increased significantly in group B (P <0.05), and the number of dry mouth in group A was significantly higher In group B (P <0.05), the amount of secretions in group B at operation was significantly higher than that in group A (P <0.05). There was significant difference between groups (P <0.05). Conclusion Penehyclidine hydrochloride, a new selective anticholinergic hydrochloride, is highly selective to M receptor. As a pretreatment drug for ketamine in children, the secretion of saliva can be significantly reduced without affecting the heart rate, blood pressure and body temperature of children, and there is no obvious adverse reaction More suitable for children with preoperative anticholinergics.