长托宁或东莨菪碱用于颈丛麻醉时对心血管不良反应的影响

目的观察对比长托宁和东莨菪碱作为术前用药分别用于颈丛麻醉时对心血管不良反应的影响。方法 60例颈丛麻醉患者随机分为氯化钠溶液组（A组,n=20）、东莨菪碱组（B组,n=20）、长托宁组（C组,n=20）,麻醉前15 min A组静脉注射氯化钠溶液1 ml,B组静脉注射东莨菪碱0.3 mg（1 ml）,C组静脉注射长托宁0.5mg（1 ml）。以0.447%甲磺酸罗哌卡因＋1%利多卡因混合液行双侧颈浅丛和一侧颈深丛神经阻滞,连续监测并记录麻醉前15 min及麻醉后5、10、15、20 min时心率（HR）、收缩压（SBP）、舒张压（DBP）变化。结果 A组麻醉后各时间点HR、SBP、DBP与麻醉前15 min比较差异有统计学意义（P〈0.05）;B组麻醉后大部分时间点HR、SBP、DBP与C组比较差异有统计学意义（P〈0.05）;A、B两组麻醉后各时间点HR较麻醉前15 min均有差异（P〈0.05）。C组麻醉后各时间点HR与麻醉前15 min比较差异无统计学意义（P〉0.05）,与A组比较麻醉后各时间点HR、SBP、DBP与麻醉前15 min比较差异有统计学意义（P〈0.01）。结论长托宁能够有效地预防颈丛麻醉导致的心血管不良反应,较东莨菪碱更适合于作为颈丛麻醉的术前用药。

Influence of Penehyclidine Hydrochloride or Scopolamine for Adverse Cardiovascular Side Effects in Anesthesia of Cervical Plexus Block

Objective To observe and compare the influence of penehyclidine hydrochloride and scopolamine as premedicate for adverse cardiovascular side effects in anesthesia of cervical plexus block.Methods 60 patients with anesthesia of cervical plexus block were divided into sodium chloride solution group（A,n=20）、scopolamine group（B,n=20） and penehyclidine hydrochloride group（C,n=20）.Before anesthesia for 15 minutes,A group received sodium chloride solution 1 ml,B group received scopolamine 0.3 mg（1 ml） and C group received penehyclidine hydrochloride 0.5 mg（1 ml）.The bilateral superficial cervical nerve plexus block and unilateral deep branches of cervical plexus block were performed with mixed liquor of 0.447% s-ropivacaine mesylate and 1% lidocaine.Before anesthesia for 15 minutes and after anesthesia for 5、10、15 and 20 minutes,the change of HR、SBP and DBP was monitored and recorded continuously.Results There was a statistic difference（P0.05） for HR、SBP and DBP in each of point-in-time after anesthesia compared with before anesthesia for 15 minutes in A group.There was a statistic difference（P0.05） for HR、SBP and DBP in most of point-in-time after anesthesia compared B group and C group.There was a statistic difference（P0.05） for HR in each of point-in-time after anesthesia compared with before anesthesia for 15 minutes in A and B group.There was no statistic difference（P0.05） for HR in each of point-in-time after anesthesia compared with before anesthesia for 15 minutes in C group.There was a statistic difference（P0.05） for HR、SBP and DBP in each of point-in-time after anesthesia and before anesthesia for 15 minutes compared A group and C group.Conclusion Penehyclidine hydrochloride can prevent the adverse cardiovascular side effects in anesthesia of cervical plexus block effectively and is mostly for premedicate than scopolamine.