麻醉前应用长托宁对高血压患者血压的影响

目的：观察长托宁作麻醉前用药对高血压患者血压的影响。方法：择期手术高血压和正常血压患者各60例．随机平均分为实验（A）组、高血压对照（B）组、药物对照（C）组和空白对照（D）组；A组再分为A1（术前3天连续使用降压药，n=12）和A2（术前3天内未用降压药，n=18）两个亚组。全组患者年龄（59．34±9．83）岁，体重（64．61±10．29）kg，男71例，女49例。入手术室后测定Bp、HR和SpO2做为基础值（T^0）。A、C组静注长托宁0．5mg。记录此后5、10、20和30min（T^5、T^10、T^20、T^30）的Bp、HR和SpO2。结果：各时点HR和SpO2组间及组内无统计学差异。A组T^10SBP、DBP和T^20SBP均低于基础值（P〈0．05）；B组T^10SBP高于A组同时点值（P〈0．05）。A组MAP基础值与给药后20min内最低值之间的差值（17．60±9．00mmHg）同基础值呈正相关（γ=0．581，P=0．002）。结论：成人高血压患者麻醉前静注0．5mg长托宁，具有持续20min以上的降压作用，特别是对血压较高或术前未用降压药物治疗的患者效果更为明显。

Effects of Penehyclidine Hydrochloride on Blood Pressure of Hypertensive Patients in Preanesthetic Medication

Objective： To investigate the effects of penehyclidine hydrochloride on blood pressure of hypertensive patients in premedication. Methods： Sixty hypertensive patients and sixty normotensive patients scheduled for elective surgery were randomly assigned to one of four equal groups ： experimental group （ Group A） ; hypertensive control group （ Group B） ; drug control group （ Group C） ; sham group （Group D）. Group A was divided into A1 group （patients continuously took hypotensive drug during three days of preoperation, n = 12 ） and A2 group （patients did not take hypotensive drug during three days of preoperation, n = 18 ）. Consisting of seventy-one men and forty-nine women, all the patients were aged 59. 34 ±9. 83, and weighed （64. 61 ± 10. 29） kg. Bp, HR and SpO2 were measured as basic values （T^0） after patients were sent to operating room. Group A and C received penehyclidine hydrochloride 0. 5 mg intravenously. Bp, HR and SpO2 were recorded respectively at the time point of 5, 10, 20 and 30 minutes （T^5 T^10, T^20 and T^30） after intravenous injection. Results： HR and SpO2 measured at each time point have no statistical difference among all groups and in each group. SBP and DBP of T^10 and SBP of T^20 in Group A were lower than basic values （P 〈 0. 05 ）, while SBP of T^10in Group B were higher than that of T^10 in Group A （P 〈 0.05）. The differences between the basic values of MAP and the minimum values of MAP during 20 minutes after intravenous injection have positive correlation with the basic values in Group A （ γ= 0. 581, P = 0. 002）. Conclusion： Penehyclidine hydrochloride （0. 5 mg） intravenously injected to hypertensive adult in preanesthetic medication maintains the antihypertensive effect for more than 20 minutes, especially having great significance to the patients who do not take hypotensive drug before operation and those with comparatively high blood pressure.