盐酸戊乙奎醚用于婴幼儿氯胺酮麻醉前用药临床探究.docVIP

盐酸戊乙奎醚用于婴幼儿氯胺酮麻醉前用药临床探究 　【摘要】 目的 对盐酸戊乙奎醚作为婴幼儿氯胺酮全身麻醉前用药进行随机观察比较。 方法 将60例施行氯胺酮全身麻醉的婴幼儿随机分成两组，盐酸戊乙奎醚组（A组）和阿托品组（B组），每组30例。分别于入室后静注盐酸戊乙奎醚0.01 mg/㎏ 或阿托品0.01 mg/㎏，行咪唑安定、氯胺酮静脉复合麻醉，记录用药前、用药后10、20、30min及输注氯胺酮后5、15 min的HR、MAP、SpO2、体温的变化，并观察60 min内口腔、颜面潮红和镇静程度。 结果 与B组比较,A组HR较稳定，B组(92.2±16.0)次/分,A组（77.3±11.4）次/分（P＜0.05)。A组婴幼儿体温轻度变化，B组婴幼儿体温升高明显（P＜0.01)。两组间比较口干、颜面潮红和镇静程度差异均无统计学意义。结论 盐酸戊乙奎醚具有显著的HR稳定、体温变化小的作用特点，对避免增快HR、体温升高的婴幼儿氯胺酮全身麻醉，盐酸戊乙奎醚是较理想的麻醉前用药。 【关键词】 盐酸戊乙奎醚； 阿托品； 氯胺酮； 术前用药 【Abstract】 Objective To observe the application of penehyclidine hydrochloride as the anesthetics before applying ketamine.Methods 60 cases of infants undertaking ketamine complete anesthesia were randomly divided into two groups,penehyclidine hydrochloride group (group A) and atropine group (group B).After entering the room,they were separately injected with 0.01 mg/kg penehyclidine hydrochloride or 0.01mg/kg atropine,undertaken compound anesthesia of midazolam and ketamine injection.The HR,MAP,SpO2 and body temperature changes at the different times of 10,20 and 30 min before and after drug application and 5,15 min before and after ketamine injection were recorded.Their mouths,flush and composure degree within 60 minutes were observed.Results Compared with group B,the HR of group A was more stable,(92.2±16.0) times/minute for group B and（77.3±11.4）times/minute for group A(Plt;0.05).Infants in group A had slight body temperature change,while infants in group B had obviously higher body temperature (Plt;0.01).There was no significance in the difference in dry mouth,flush and composure degree between the two groups.Conclusion Penehyclidine hydrochloride had the features of remarkable HR stability and slight body temperature change.It is the ideal medication prior to anesthesia in infants receiving conplete anesthesia of ketamine to avoid HR and body temperature increasing. 【Key words】 penehyclidine hydrochloride；atropine；ketamine；medication prior to surgery 近年来，国内针对盐酸戊乙奎醚用法的报道很多，但对于盐酸戊乙奎醚应用于婴幼儿氯胺酮全身麻醉术