Background. General anesthesia (GA) is the core means of surgical intervention, mainly used for analgesia and anxiety relief. Therefore, it is necessary to understand the laboratory and clinical research results during induction of GA. Penehyclidine hydrochloride (PHCD) combined with atropine sulfate (Atr) has the potential to induce GA. However, the role of PHCD combined with Atr during tracheal intubation under GA remains unclear. Objective. The research is aimed at exploring the effects of preoperative PHCD or Atr on adverse reactions (ARs) in patients during tracheal intubation under general anesthesia (GA). Methods. This study retrospectively enrolled 473 patients who underwent surgery under GA induction and divided them into a research group ( n = 234 ) and a control group ( n = 239 ) according to preoperative use of PHCD (with or without). Both groups of patients were given Atr postoperatively and nursing intervention. Anesthesia-related indexes, ARs, and hemodynamics were observed and compared between the two groups. Results. There were no significant differences in anesthesia-related indexes and hemodynamics between the research group and the control group. The incidence of blurred vision and diplopia in the research group was higher than that in the control group. Conclusion. Preoperative PHCD combined with postoperative Atr should be avoided in clinical practice, or Atr rather than PHCD should be used preoperatively, so as to reduce the occurrence of blurred vision, diplopia, and other ARs.
Backgroud During the induction of general anesthesia, opioids and endotracheal intubation may cause coughing. This study aimed to determine the safety and clinical effects of an optimized drug induction scheme for general anesthesia to prevent coughing in patients. Methods A total of 220 patients aged 18 to 65 years who underwent surgery under general anesthesia with endotracheal intubation were randomly assigned to two groups with 110 cases each; one group was administered with a divided sufentanil bolus (group A) and the other with a single sufentanil bolus (group B). Anesthesia induction was performed according to the drug induction scheme of 0, 1, and 3 min. In group A, intravenous sufentanil was administered at 0.1 µg/kg for 2–3 s; intravenous propofol was administered at 1 min for 20–30 s, rocuronium bromide for 10–15 s, and the remaining sufentanil for 3–5 s after rocuronium bromide administration. In group B, sufentanil was administered intravenously after rocuronium bromide was administered once, and the doses and bolus injection rates of the remaining drugs were the same as those in group A. The primary outcome was a cough reaction caused by opioids. We also recorded the pain associated with drug injection, hemodynamics, and blood oxygen saturation during the induction of general anesthesia. Results All patients were included in the statistical analysis. There were 10 cases of sufentanil-induced choking reactions in group A and 0 cases in group B, and the difference was statistically significant (P < 0.05). There was no choking reaction of tracheal intubation in the two groups (both P > 0.05). There was no severe pain due to propofol and rocuronium injection in the two groups (P > 0.05). The mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) values were within the normal range at each time point during the induction period. Conclusion Following the concise general anesthesia induction scheme at 0, 1, and 3 min, an optimized general anesthesia induction regimen of rocuronium bromide that was rapidly administered, and a single final intravenous bolus of sufentanil, sufentanil-induced coughing reaction was completely eliminated. Trial registration: Chinese Clinical Trial Registry: ChiCTR2200062749 (registration date: 17/08/2022).
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