不同剂量及途径应用长托宁的效果观察

目的观察不同剂量及途径应用长托宁的临床效果及其安全性。方法160例择期全麻手术病人,根据麻醉前用药均分为8组:Ⅰ组肌注长托宁0.5mg;Ⅱ组肌注长托宁1.0mg;Ⅲ组肌注阿托品0.5mg;Ⅳ组肌注东莨菪碱0.3mg;Ⅴ组静注长托宁1.0mg;Ⅵ组静注阿托品0.5mg;Ⅶ组静注东莨菪碱0.3mg;Ⅷ组静注生理盐水1.0ml。观察用药前、后30分钟心率、血压、口干、术中从气道吸引出分泌物、以及药物副作用等情况。结果Ⅰ～Ⅳ各组药物肌注后血压无明显变化(P>0.05),Ⅲ组肌注阿托品后心率稍有升高(P<0.05)。Ⅵ、Ⅶ组静注阿托品、东莨菪碱后心率、血压升高(P<0.01),但Ⅴ组静注长托宁后心率、血压无明显变化。Ⅰ～Ⅶ各组药物肌注或静注后口干明显,与Ⅷ组相比,P<0.01。Ⅰ、Ⅲ、Ⅳ、Ⅵ、Ⅶ组术中、术毕拔管时从口腔、气管内吸引出分泌物量与Ⅷ组相比,P<0.05;而Ⅱ、Ⅴ组与Ⅷ组相比,P<0.01。未发现有关长托宁的药物副作用。结论临床剂量长托宁(1.0mg疗效更佳)具有明显抑制气道腺体分泌作用,且对心率无影响,应用范围广,毒副作用少。

The comparative study of different does and administration of penehyclidine hydrochloride

Objective To evaluate the therapeutic efficiency and safety of penehyclidine hydrochloride by different dose and administration.Methods One hundred sixty patients undergoing general anesthesia were randomly divided into eight groups according to premedication:received intramuscularly penehyclidine hydrochloride 0.5 mg or 1.0 mg(group Ⅰ,group Ⅱ),atropine 0.5 mg (group Ⅲ),scopolamine 0.3 mg(group Ⅳ),and administered intravenously penehyclidine hydrochloride 1.0 mg(group Ⅴ),atropine 0.5 mg (group Ⅵ),scopolamine 0.3 mg (group Ⅶ),normal saline 1.0 ml (group Ⅷ).The heart rate,blood pressure and thirst were observed before and 30 min after premedication.The secretion of trachea and salivary gland,and adverse events were evaluated during operation.Results In group Ⅰ,Ⅱ and Ⅴ, the change of heart rate and blood pressure were not significantly after premedication. In group Ⅵ,Ⅶ, the heart rate and blood pressure increased significantly after injecting. In group Ⅰ~Ⅶ, the degree of thirst and the secretion amount of trachea and salvary gland had significant difference compared with group Ⅷ after premedication, the secretion amount of gland in group Ⅱand Ⅴwas less than that in group Ⅰ,Ⅲ,Ⅳ,Ⅵ,Ⅶ. There was no side effect observed.Conclusion As premedication, penehyclidine hydrochloried (the best with 1.0 mg) can be used effectively and safely to decrease the secretion of trachea and salivary gland without any increase in heart rate.