麻醉诱导期间的心血管变化。三种抗胆碱能术前用药的影响。
Cardiovascular changes during induction of anaesthesia. Influence of three anticholinergic premedicants.
作者信息
Mirakhur R K, Dundee J W
出版信息
Ann R Coll Surg Engl. 1979 Nov;61(6):463-9.
The effects on cardiovascular changes during induction of anaesthesia and intubation of routine premedication with three different anticholinergic drugs, atropine, hyoscine, and glycopyrronium, were compared in a double blind trial. Administration of both atropine and hyoscine, whether intramuscularly or orally, was found to be associated with a high incidence of dysrhythmias. With glycopyrronium the incidence was much lower, but control patients receiving no anticholinergic premedication had no dysrhythmias. The heart rates and blood pressures were similar in all the groups during intubation and cuff inflation. A single dose of suxamethonium was not associated with any bradycardia. The need for routine anticholinergic drug administration should be reconsidered. However, if necessary, glycopyrronium appears to have an obvious advantage over atropine and hyoscine.
在一项双盲试验中，比较了三种不同抗胆碱能药物（阿托品、东莨菪碱和格隆溴铵）进行常规术前用药时，对麻醉诱导和插管期间心血管变化的影响。发现无论是肌肉注射还是口服阿托品和东莨菪碱，都与心律失常的高发生率相关。使用格隆溴铵时发生率要低得多，但未接受抗胆碱能术前用药的对照患者没有出现心律失常。在插管和袖带充气期间，所有组的心率和血压相似。单剂量琥珀酰胆碱与任何心动过缓均无关。应重新考虑常规使用抗胆碱能药物的必要性。然而，如有必要，格隆溴铵似乎比阿托品和东莨菪碱具有明显优势。
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