盐酸戊乙奎醚减少脑瘫患儿全身麻醉下颈动脉外膜剥脱术后口腔分泌物过多的临床观察

目的研究需要行颈动脉外膜剥脱术脑瘫患儿全身麻醉（全麻）诱导时给予盐酸戊乙奎醚预防术后口腔分泌物过多的效果。方法2009年12月-2011年12月选择60例美国麻醉医师协会分级Ⅰ-Ⅱ级的需要在全麻下行颈动脉外膜剥脱术的脑瘫患儿，随机分为两组，每组30例。A组于麻醉诱导时静脉注射阿托品10gg／kg，B组于麻醉诱导时静脉注射戊乙奎醚10gg／kg。分别记录两组的麻醉持续时间、人室心率、气管插管后10min的心率差、停药后的拔管时间及拔管时口腔分泌物评分采用视觉模拟评分法（VAS）]。结果两组相比，患儿麻醉持续时间、人室心率和停药后拔管时间差异均无统计学意义（P〉0．05），而拔管时口腔分泌物的VAS评分差异有统计学意义（P〈0．05），其中口腔分泌物过多（VAS〉2分），A组为46．67％，B组为16．67％，B组比A组口腔分泌物更少，气管插管后10min心率A组为（28．30±9．73）次／min，B组为（9．93±10．25）次／min，两组差异有统计学意义（P〈0．05）。结论盐酸戊乙奎醚能够有效减少需要行颈动脉外膜剥脱术的脑瘫患儿术后口腔分泌物过多的情况，且比常规应用阿托品的效果更好。

Clinical Observation of Penehycfidine Hydrozhloride Reducing Excessive Oral Secretion in Children with Cerebral Palsy after Free and Excision of Sympathetic Plexus of Common Carotis Artery under General Anesthesia

Objective To investigate the results of penehyclidine hydrozhloride prevention of oral gland secretion following free and excision of sympathetic plexus of common carotis artery （FES-CCA） in children with cerebral palsy under general anesthesia. Methods A total of 60 children with cerebral palsy following FES-CCA were performed general anesthesia between December 2009 and December 2011. The ASA grade were 1-2. All cases were randomized into atropine group （group A, n=30） and penehyclidine hydrozhloride group （group B, n=30）. Atropine （10 μg/kg） and penehyclidine hydrozhloride were injected into group A and B during induction of anesthesia, respectively. The following variables were analyzed, including the duration of anesthesia, heart rate when enter operation room, heart rate difference after tracheal intubation 10 rain, extubation time, visual actinal secreta when extubation. Results There were no significant difference in duration of anesthesia and heart rate when enter operation room and extubation time between the two groups （all P 〉 0.05）. The visual actinal secreta when extubation was significantly lower in group B than one in group A （group A was 46.67%, group B was 16.67%, P 〈 0.05））. The heart rate variation （BPM） （group A was 28.30 ± 9.73, group B was 9.93 ± 10.25） after tracheal intubation 10 minutes was significantly more in group A than that in group B （P 〈 0.05）. Conclusion The penehyclidine hydrozhloride can effectively decrease the oral gland secretion following FES-CCA in children with cerebral palsy with general anesthesia, and is better than atropine.