摘要
目的研究盐酸戊乙奎醚对全麻机械通气患者肺胸顺应性(Comp)的影响。方法40例ASAⅠ级拟行气管插管全身麻醉的择期手术患者,随机均分为观察组和对照组。所有患者诱导前静脉注射咪唑安定0.03 mg/kg,以丙泊酚2～2.5 mg/kg、芬太尼3μg/kg、维库溴铵0.1 mg/kg静脉诱导;采用压力控制机械通气使呼气末二氧化碳分压(PETCO2)维持在正常范围;丙泊酚、维库溴铵持续输注维持麻醉。诱导后20 min,观察组静脉给予盐酸戊乙奎醚0.02 mg/kg,对照组给予生理盐水。监测给药前(T0)、给药后5 min(T5)、10 min(T10)、20 min(T20)、30 min(T30)的HR、MAP、SpO2、PETCO2、潮气量(VT)、Comp和T0、T30时的血气分析。结果两组HR、MAP差异无统计学意义。T5、T10、T20、T30时观察组VT、Comp均明显高于T0时(P<0.05或P<0.01),T20、T30时观察组的VT明显高于对照组(P<0.05)。结论对于全麻患者,盐酸戊乙奎醚可以扩张支气管,改善Comp且对血流动力学无明显影响。
Objective To investigate the effect of penehyclidine hydrochloride on pulmonary compliance under mechanical ventilation during general anesthesia. Methods Forty ASA class Ⅰ patients aged 24-76 years old with body mass index 18-25 kg/m^2 scheduled for elective operation under general anesthesia were studied. The patients were randomly divided into experimental group and control group with 20 cases each. Midazolam 0.03 mg/kg was given iv. as premedication. Anesthesia was induced with propofol 2-2. 5 mg/kg, fentanyl 3 μg/kg, vecuronium 0. 1 mg/kg. Pressure controlled ventilation （PCV） was performed after tracheal intubation, PETCO2 was maintained at normal range. Anesthesia was maintained with propofot and vecuronium continuous intravenous infusion. Penehyclidine hydrochloride 0.02 mg/kg was administered in experimental group and normal saline was injected in control group at 20 min after intubation. HR, MAP, SpO2, PET CO2, tidal volume （VT ） and pulmonary compliance（Comp） were monitored and recorded immediately before penehyclidine （To） and at 5（T5 ）, 10（T10 ）, 20（T20 ） and 30 rain（T30 ） after penehyclidine injection. Arterial blood gases were analyzed at To and T30. Results Compared with those in control group, HR and MAP were not significantly changed in experimental group. Vr and Comp significantly increased after medication in experimental group compared with those before. Conclusion During general anesthesia penehyclidine hydrochloride not only has less influence on hemodynamics but also could dilate bronchus and increase pulmonary compliance.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第10期839-842,共4页
Journal of Clinical Anesthesiology
关键词
盐酸戊乙奎醚
机械通气
肺胸顺应性
Penehyclidine hydrochloride
Mechanical ventilation
Pulmonary compliance
