Effects of penehyclidine hydrochloride combined with low tidal volume ventilation on lung function in patients with lower abdominal operation / 中国医师进修杂志

ABSTRACT

Objective To investigate the effect of penehyclidine hydrochloride combined with low tidal volume ventilation on lung function in patients with lower abdominal operation.Methods Sixty elderly patients who underwent elective lower abdominal operation were divided into three groups by random digits table method:the conventional tidal volume group (group A),penehyclidine hydrochloride combined with conventional tidal volume group (group B) and penehyclidine hydrochloride combined with low tidal volume group (group C),20 cases in each group.The patients in group B and group C were given penehyclidine hydrochloride 0.01 mg/kg before induction of anesthesia.The patients in group A were given equal volume of saline.After induction of anesthesia and mechanical ventilation modesthe patients in group A and group B were given tidal volume 10 ml/kg,the patients in group C were given tidal volume 6 ml/kg.After mechanical ventilation in anesthetized (T1),1 h after anesthesia (T2),2 h after anesthesia (T3),8 h after anesthesia (T4),24 h after anesthesia (T5),the level of tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),pH,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),the calculation of oxygenation index (PaO2/FiO2) were measured and compared.The pulmonary complications after operation 1 day were recorded.Results The level of TNF-α,IL-6 in three patients at T1 had no significant difference (P ＞ 0.05).The level of TNF-α,IL-6 at T2-5 in group C were significantly lower than those in group A and group B (P ＜ 0.05).Compared with group A and group B,the level of PaO2 and PaO2/FiO2 at T2-5 were increased in group C (P ＜ 0.05).None pulmonary complications were occurred in three groups.Conclusions Penehyclidine hydrochloride combined with low tidal volume ventilation may improve arterial oxygen in patients with lower abdominal operation,reduce the lung injury induced by mechanical ventilation,protective effect on lung function.