Clinical observation of selective cholinoceptor-M antagonist penehyclidine hydrochloride in neurosurgical preoperational medication

Objective To compare the effectiveness of selective cholinoceptor-M antagonist penehyclidine hydrochloride and atropine as preoperational medication in neurosurgery. Methods A total of 60 patients, including glioma 30 cases, meningioma 16 and acoustic neuroma 14, scheduled for selective neurosurgical operation were randomly divided into three groups, 20 patients for each group, ie. control group without preoperational medication of receptor-M antagonist; atropine group and penehyclidine hydrochloride group, the patients were intramuscularly injected with 0.5 mg atropine or penehyclidine hydrochloride respectively 30 min before anesthesia induction. The difference was not significant among the three groups in comparing the parameters of age, sex, body mass, operation time and tumor classification(P 0.05). The intensity of xerostomia after administration of receptor-M antagonist and before anesthesia induction, the volume of airway secretion and the heart rate of each patient were recorded in 5 min, 1 h, 2 h after insertion of tracheal cannula and at extubation postoperation. Results (1) After administration of drugs, the patients in both atropine group and penehyclidine hydrochloride group occurred xerostomia. (2) The volume of airway secretion in patients in atropine group and penehyclidine hydrochloride group was significantly less than that in control group during pre-induction to post-tracheal cannula insertion in different time intervals (P 0.05), but there was no significant difference between atropine group and penehyclidine hydrochloride group (P 0.05); after operation and extubation, the volume of airway secretion in atropine group was much more than that in penehyclidine hydrochloride group (P 0.05), but there was no significant difference between atropine group and control group (P 0.05). (3) After administration of drug, the patients' heart rate in atropine group increased significantly than that in control group and penehyclidine hydrochloride group (P 0.05) but in different time intervals after tracheal cannula insertion and extubation, the patients' heart rates were no significant difference among the three groups (P 0.05). Conclusion The administration of penehyclidine hydrochloride, a selective receptor-M antagonist, as preoperational medication is more effective and better than atropine in neurosurgery.