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目的研究需要行颈动脉外膜剥脱术脑瘫患儿全身麻醉(全麻)诱导时给予盐酸戊乙奎醚预防术后口腔分泌物过多的效果。方法 2009年12月-2011年12月选择60例美国麻醉医师协会分级Ⅰ～Ⅱ级的需要在全麻下行颈动脉外膜剥脱术的脑瘫患儿,随机分为两组,每组30例。A组于麻醉诱导时静脉注射阿托品10μg/kg,B组于麻醉诱导时静脉注射戊乙奎醚10μg/kg。分别记录两组的麻醉持续时间、入室心率、气管插管后10 min的心率差、停药后的拔管时间及拔管时口腔分泌物评分[采用视觉模拟评分法(VAS)]。结果两组相比,患儿麻醉持续时间、入室心率和停药后拔管时间差异均无统计学意义(P>0.05),而拔管时口腔分泌物的VAS评分差异有统计学意义(P<0.05),其中口腔分泌物过多(VAS>2分),A组为46.67%,B组为16.67%,B组比A组口腔分泌物更少,气管插管后10 min心率A组为(28.30±9.73)次/min,B组为(9.93±10.25)次/min,两组差异有统计学意义(P<0.05)。结论盐酸戊乙奎醚能够有效减少需要行颈动脉外膜剥脱术的脑瘫患儿术后口腔分泌物过多的情况,且比常规应用阿托品的效果更好。
Objective To study the effect of penehyclidine hydrochloride on the prevention of postoperative oral secretions induced by general anesthesia (general anesthesia) in children with cerebral palsy undergoing carotid endarterectomy. Methods From December 2009 to December 2011, 60 children with cerebral palsy undergoing carotid endarterectomy under general anesthesia were randomly divided into two groups (n = 30 in each group): 60 cases of American Society of Anesthesiologists grade Ⅰ ~ Ⅱ. A group of intravenous injection of atropine 10μg / kg at induction of anesthesia, B group intravenous penehyclidine 10μg / kg at induction of anesthesia. The duration of anesthesia, heart rate, heart rate difference at 10 min after tracheal intubation, extubation time after extubation, and oral secretions score during extubation (visual analogue scale (VAS)] were recorded respectively. Results There was no significant difference in the duration of anesthesia, heart rate and the time of extubation after stopping the treatment in both groups (P> 0.05), while there was significant difference in the VAS scores of oral secretions during extubation (P (P <0.05). Excessive oral secretions (VAS> 2 points), A group was 46.67%, B group was 16.67%, B group than A group oral secretions less, 10 min after tracheal intubation group A heart rate (28.30 ± 9.73) times / min in group B and (9.93 ± 10.25) times / min in group B, respectively. There was a significant difference between the two groups (P <0.05). Conclusion Penehyclidine hydrochloride can effectively reduce the excess oral secretions in children with cerebral palsy who require carotid endarterectomy, which is better than the routine use of atropine.