Clinical Observation Of Penehychidine Hydrochloride Pretreatment In Combined Spinal-epidural Anesthesia

Object: to study the effect of Penehychidine Hydrochloride pretreatment in combinedspinal-epidural anesthesia to prevent the perioperative shivering, maintainhemodynamic stability and keep calm.Methods:80patients undergoing elective whole hysterectomy,ASAI~II,weight50~70kg,age45~60years old, height155~165cm, BMI18~25kg/m2patientsrandomly divided into two groups: group A (Penehychidine Hydrochloride group) andgroup B (blank group).In5min before the start of anesthesia, group A was givenPenehychidine Hydrochloride0.01mg/kg (diluted with normal saline to2ml),group B was given the same volume of normal saline.Then Patients take the right side,in the L2-3piercing into the subarachnoid space gaps and uniform push0.75%ofbupivacaine2.0ml (within10to20sec), catheter in the epidural space.Intraoperativelumbar hemp according to function loss situation, as appropriate, adding lidocaine3~5ml by the epidural catheter. Continuous monitoring ECG, NIBP, and record thebefore injection (T1), cut skin (T2), pull the peritoneum (T3), probing basin celiac(T4), pull the uterus (T5), closed abdomen (T6), end of surgery (T7has), record theheart rate (HR) and mean arterial pressure (MAP) of every time.Patient’s homeinvasion of HR and MAP by patients in surgical bed repose after10minutes of HRand MAP.Observe incidence of shivering.Observe and record sedation scores(Ramsay score).Results:(1) the general situation of two groups of patients, two groups of patientswith ASA grade, age, weight, infusion, blood loss, amount of urine, flushing and thedifferences of operation time has no statistical significance (P>0.05).(2) two groupsof patients after anesthesia, and the MAP are decreased, compared with when the before injection was statistically significant (P <0.05), at the end of the surgery torestore to the basic level.Two groups of patients were to pull the uterus MAP, MAPgroup B lower than group A with statistical significance (P <0.05), no statisticaldifference between the rest groups at each time point (P>0.05).Comparison in thegroup, HR and foundation each time point compared with no significant difference (P>0.05) in group A, while group B in the retraction of the peritoneum, abdominalexploration and pull the uterus heart rate decreased,(T3, T4, T5) compared with T1,was statistically significant (P <0.05).Comparison between groups, two groups ofpatients when pull the uterus HR difference was statistically significant (P <0.05),and the rest had no significant difference at each time point (P>0.05).(3) sedationscore of group A was obviously higher than that of group B (P <0.05).Uponexamination, the incidence of shivering similar between the two groups havestatistical significance (P <0.05).No difference between the two groups of patientsthe incidence of nausea and vomiting (P>0.05).Conclusion: Penehychidine Hydrochloride pretreatment in combined spinal-epiduralanesthesia for patients with stable hemodynamics, reduce the incidence of shivering,and increase patients satisfaction with calm, without the occurrence of adverse drugreactions.