Suzuki Satomi, Nonaka Akihiko, Abe Fumiaki
Department of Anesthesia, Yamanashi Prefectural Central Hospital, Yamanashi 400-8506.
Masui. 2005 Nov;54(11):1277-81.
Scopolamine butylbromide (hyoscine-N-butylbromide, HB) is an anticholinergic drug used as a smooth muscle relaxant, and is used even in some surgical procedures during general anesthesia. HB also causes an increase in heart rate as a side effect. The authors evaluated the efficacy of esmolol on hemodynamic changes induced by HB in major abdominal surgery under inhalation anesthesia.
Seventeen patients for major abdominal surgery were randomly assigned to control group (C group, n = 9) or to esmolol group (E group, n = 8). Anesthesia was induced with propofol and was maintained with isoflurane-nitrous oxide inhalation and intermittent administration of fentanyl and vecuronium. At the time of bowel anastomosis, 20 mg of HB was administrated as an antispasmodic. In E group, esmolol 0.6 mg x kg(-1) was administered immediately after HB administration.
There were no differences in the patient background between the two groups. At 1 to 10 minutes after HB administration, heart rate increased significantly compared with that at pre-administration in C group, while there was no significant change in heart rate in E group. Heart rate in E group was significantly lower than that in C group at 2 and 3 minutes after HB administration. Blood pressure was not significantly changed in both groups during the observation period.
The simultaneous administration of HB and esmolol was useful for heart rate control after HB administration.
丁溴东莨菪碱（消旋山莨菪碱-N-丁基溴化物，HB）是一种抗胆碱能药物，用作平滑肌松弛剂，甚至在全身麻醉的一些外科手术中使用。HB还会引起心率增加这一副作用。作者评估了艾司洛尔对吸入麻醉下腹部大手术中HB诱导的血流动力学变化的疗效。
17例腹部大手术患者随机分为对照组（C组，n = 9）或艾司洛尔组（E组，n = 8）。用丙泊酚诱导麻醉，并用异氟烷-氧化亚氮吸入及芬太尼和维库溴铵间歇给药维持麻醉。在肠吻合时，给予20 mg HB作为解痉剂。在E组，在给予HB后立即给予0.6 mg·kg-1的艾司洛尔。
两组患者的背景无差异。在给予HB后1至10分钟，C组心率较给药前显著增加，而E组心率无显著变化。在给予HB后2和3分钟，E组心率显著低于C组。在观察期内两组血压均无显著变化。
同时给予HB和艾司洛尔有助于控制HB给药后的心率。
