Effect of penehyclidine hyrochloride and positive end - expiratory pressure on respiratory function during laparoseopic surgery

LIANG Xiao-jing; GAO Dong-yan

Abstract：Objective:To investigate the effect of penehyclidine hyrochloride and positive end - expiratory pressure (PEEP)on respiratory function during gynecologic laparoseopic surgery. Methods:Eighty patients scheduled for gynecologic laparoscopic surgery under general anesthesia were randomly divided into four groups with each group 20 cases:group Ⅰ was treated with intravenous injection of 1 mL saline at 1 0 min before intubation ,PEEP value was set to 0 cm H2 O( 1 cm H2 O =0. 098 kPa);group Ⅱ was intravenous injection of 1 mg penehyclidine hyrochloride at 10 min before intubation,PEEP value was set to 0 cm H2 O;group Ⅲ was 1 mL saline and PEEP value was set to 5 cm H2 O;group Ⅳ was 1 mg penehyclidine hyro-chloride and PEEP value was set to 5 cm H2 O. Plat pressure( Plat),peak airway pressure( Peak),respiratory resistance (Raw),partial pressure of carbon dioxide in endexpiratory gas(PetCO2 )and arterial blood gas were recorded before injection (To),before pneumoperitoneum(T1),at 30(T2),60(T3)nmin after pneumoperitoneum and at 10min after anesthesic(T4). Results:Plat,Peak,Raw increased significantly(P < 0. 01)after pneumoperitoneum in four groups,and groupⅡ < group Ⅳ <groupⅢ组(P < 0. 01);PetCO2 increased significantly(P < 0. 01)after pneumoperitoneum,and group Ⅳ was less than groupⅠ(P < 0. 05). T2,T3 compared to T1,arterial partial pressure of oxygen(PaO2 )[alveolar arterial blood oxygen tension differ-ence(A - aDO2 )]decreased(increased)significantly in group Ⅰ,and tended to decrease(increase)in group Ⅱ,while to increase(decrease)in group Ⅲ,Ⅳ. Pa02 was more in group Ⅳ than other groups at T2 - 4,while arterial carbon dioxide pres-sure(PaCO2 ),A - aDO2 was lower. Conclusion:Intravenous injection of penehyclidine hyrochloride before intubation and intr-aoperative management with PEEP can improve the effect of pneumoperitoneum on respiratory function during gynecology lapa-roseopic surgery,and the overall effect is better than that of the two separate effects.