Effect of different administration routes of penehyclidine hydrochloride on respiratory mechanics of patients undergoing gynecological laparoscopic surgery

Abstract:

Objective: To investigate the effects of different administration routes of intravenous drip and aerosol inhalation of penehyclidine hydrochloride (PCHE) on respiratory mechanics of patients undergoing gynecological laparoscopic surgery. Methods: A total of 150 patients undergoing gynecological laparoscopic surgery in Sichuan Provincial People's Hospital were randomized into intravenous drip group, aerosol inhalation group and blank control group, with 50 cases in each group. The three groups of patients were given intravenous drip with PCHE 1 mL, aerosolinhalation with PCHE 1 mL and intravenous drip with saline 1 mL 15 min before induction of anesthesia, respectively. Respiratory mechanics indexes (Peak, Raw, Plat, PetCO₂), circulatory mechanics indexes (HR, BP) and blood gas analysis indexes (PaO₂, PaCO₂, PaO₂/FiO₂) were collected before artificial pneumoperitoneum (T₁), 30 min after pneumoperitoneum (T₂), 60 min after pneumoperitoneum (T₃) and 10 min after extubation (T₄). Results: At T₂ and T₃, the Peak, Plat and Raw values of intravenous drip group and aerosol inhalation group were significantly lower than those of blank control group (P<0.05), and the respiratory mechanics indexes of aerosol inhalation group were significantly lower than those of intravenous drip group (P<0.05). At T₂, T₃ and T₄, the PaO₂ and PaO₂/FiO₂ values of aerosol inhalation group and intra venous drip group were significantly higher than those of blank control group (P<0.05), PaO₂ and PaO₂/FiO₂ values of aerosol inhalation group at T₂ and T₃ were significantly higher than those of intravenous drip group (P<0.05). PaCO₂ values of aerosol inhalation group and intravenous drip group at T₂, T₃ and T₄ were significantly lower than those of blank control group (P<0.05). And there was no significant difference in PaCO₂ values between intravenous drip group and aerosol inhalation group (P>0.05). There was no significant difference in HR and BP values among the three groups (P>0.05). There was no significant difference in respiratory mechanics index, circulatory mechanics index and blood gas analysis index among the three groups after the change of body position (P>0.05). Conclusion: Artificial pneumoperitoneum during gynecological laparoscopic surgery could cause changes in respiratory tract mechanics and blood gas analysis. PCHE can effectively improve the airway pressure and internal respiratory environment of patients, which provides a scientific basis for clinical administration and anesthesia management in gynecological laparoscopic surgery.