盐酸戊乙奎醚应用于小儿氯胺酮麻醉前用药

【目的】探讨盐酸戊乙奎醚作为全麻术前用药在减少腺体分泌以及对循环功能、体温的影响及其用于术前用药的安全性和有效性。【方法】手术患儿60例，随机分为盐酸戊乙奎醚组（A组）和东莨菪碱组（B组），每组30例。两组均于术前30min分别肌注盐酸戊乙奎醚（0．01mg／ks）和东莨菪碱（0．01mg／kg）。静脉给予氯胺酮（1mg／kg）常规复合臂丛神经阻滞（利布合剂0．5mL／kg），记录给药前15min、给药后15min、20min、30min，给氯胺酮15min后血压（BP）、心率（HR）、脉搏血氧饱和度（SPO2）、体温（T）、呼吸道唾液分泌物、面色、皮肤、口干等情况。【结果】B组术前及用药后HR、BP均比A组升高（P〈0．05）。氯胺酮麻醉后，B组HR、BP与A组比较差异无统计学意义（P〉0．05）。SPO2两组时点值无显著差别，B组用药后30min后T升高，呼吸道分泌物明显多于A组。【结论】盐酸戊乙奎醚具有显著的心率稳定作用及强大持久的腺体分泌抑制作用，作为术前用药效果满意且优于东莨菪碱，可安全用于小儿全麻手术术前给药。

Effect of Intravenous Penehyclidine Hydrochloride Before General Anesthesia of Ketamine

Objective]To explore the efficiency and safety of penehyclldine hydrochloride as a preoperative anesthetic by observing its effects on the secretion of gland, blood circulation and body temperature. Methods] Sixty children aged 4-7 years undergoing general anesthesia of ketamine （KT） were randomly assigned to Group A （scopolamine, SCOP, n =30） and G-roup B （penehyclidine hydrochloride, PHC, n =30）. PHC （0.01 mg/kg） was administered i.m. to Group A and SCOP （0.01 mg/kg） i.m. to Group B at 30min before operation. Conventional composite lidocaine/bupivacaine brachiai plexus block and KT （lmg/kg iv. ） anesthe- sia were performed. Discontinuous supplementary KT （0.5-1 mg/kg） was given for the maintenance of anes- thesia. In the course of surgery, spontaneous breathing was maintained. Blood pressure（BP）, heart rate （ HR）, SPO2, T, salivary secretion from respiratory tract, complexion, skin and dry mouth, etc. were recor ded at 15min before medication, and 15, 20, and 30min after medication and 15min after KT administration. Results] Emotional stability was seen both groups. There was no significant difference in SPO2 between the two groups. BP and HR in Group B were higher than those in Group A （P〈0.05） before operation and after medication. There were no significant differences in BP and HR between the two groups after KT anesthesia （P〉0.05） . The body temperature in Group B increased obviously after medication compared with Group A（P〈0.05）. Salivary secretion from respiratory tract in Group A was more than that in Group B. Conclusion] Penehyclidine hydrochloride has the effects of inhibiting secretion of salivary gland and maintaining cardiovas- cular stability, so it is a proper premedieation of children patients undergoing general anesthesia.