ผลของการให้ glycopyrrolate ก่อนการนำสลบเพื่อช่วยลดภาวะแทรกซ้อนจากยา propofol  และลดสารคัดหลั่งขณะจัดท่าทาง ในผู้ป่วยผ่าตัดนิ่วที่ไตและท่อไตแบบเปิด

Kamoltip Prasopsuk; Songwut Prasopsuk; Suppadech Tunruttanakul

Authors

Kamoltip Prasopsuk โรงพยาบาลสวรรค์ประชารักษ์
Songwut Prasopsuk โรงพยาบาลสวรรค์ประชารักษ์
Suppadech Tunruttanakul โรงพยาบาลสวรรค์ประชารักษ์

Keywords:

Propofol, Hypotension, Bradycardia, Salivation

Abstract

Objectives : To study the effects of intravenous glycopyrrolate during the induction by propofol whether it can alleviate hemodynamic deleterious effect and can reduce salivary.

Setting : Operating Room Floor 4, Sawanpracharak Hospital

Design : Randomized control trial, double-blind controlled trial

Subjects : 64 elective open urologic patients, ASA I - II

Methods : Patients were randomly allocated to one of two groups to receive NSS 1 ml (Group C) and glycopyrrolate 0.2 mg (Group G). Group G was given glycopyrrolate 0.1 mg injection 0, 2 min after start doses of propofol. Anesthesia was induced with propofol 2.5 mg/kg by titration and cisatracurium 0.2 mg/kg was given immediately. The total time for induction was 5 minutes. Blood pressure, heart rate and salivary volume were measured at 2, 3, 5, 5.5 (intubation time) and 7 minutes, accordingly.

Results : Hypotension (56.3% vs 34.4%, p-value=0.13) incidence was insignificantly reduced in the glycopyrrolate group and significantly reduced bradycardia (15.6% vs 7.8% p-value =0.05), salivary volume (9.5 vs 0.5 ml, p-value< 0.01)

Conclusion : Glycopyrrolate is effective in preventing bradycardia and reducing salivary volume. But it cannot attenuate the hypotension caused by anesthesia with propofol.

Keywords : Propofol, Hypotension, Bradycardia, Salivation

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คณะอนุกรรมการพัฒนาบัญชียาหลักแห่งชาติ และคณะทำงานผู้เชี่ยวชาญแหงชาติด้านการคัดเลือกยา สาขาวิสัญญีวิทยา และการระงับการปวด. คู่มือการใช้ยาอย่างสมเหตุผลตามบัญชียาหลักแห่งชาติ ยาที่ใช้ทางวิสัญญีวิทยา และการระงับปวด. นนทบุรี: กลุ่มนโยบายแห่งชาติด้านยา สำนักยา สำนักงานคณะกรรมการอาหารและยา; 2559.