目的:探讨在全凭静脉麻醉及脑电双频指数监测下静脉注射盐酸戊乙奎醚注射液(penehyclidine hydrochloride,PHC)对乳腺癌手术患者术中知晓发生的影响.方法:400例择期行乳腺癌手术的患者随机分为研究组(n=200)和对照组(n=200),分别于术前30 min静脉注射0.01 mg/kg PHC或等容量的0.9%氯化钠液.采用改良Brice interview问卷调查方式,在术后2~6 h和24~48 h分别进行2次随访,调查并记录患者主诉情况.由对分组不知情的3位麻醉医师分别独立判断是否发生术中知晓,至少有2位同时认定才能确认为术中知晓.结果:研究组术中知晓发生率为0% (0/200),对照组术中知晓发生率为2.5% (5/200),2组差异有统计学意义(P<0.05).结论:盐酸戊乙奎醚注射液可以减少全麻乳腺癌手术患者术中知晓的发生率.%Objective:To evaluate the effects of pcnchyciidinc hydrochioridc (PHC) on the incidence of intraopcrativc awareness in patients undergoing breast cancer surgery under bispcctrai index guided total intravenous anesthesia. Methods: A total of 400 patients scheduled for breast cancer surgery were randomly divided into cither the PHC group (receiving 0. 01 mg/kg PHC intravenously 30 min before surgery) or the saline group (receiving saline intravenously as placebo). Intraopcrativc awareness was defined as postoperative recall of events occurring during operation. Modified Bricc interview was used to assess awareness in the study. Patients were interviewed between 2 h and 6 h postopcrativcly, as well as between 24 h and 48 h post-opcrativcly. A committee of three experts blinded to the study conditions, independently scrutinized all reported recollections. Confirmed awareness was defined as two or three coding 'awareness'. Results: None of 200 (0%) and 5 of 200 (2. 5%) who received PHC and saline, respectively, were reported awareness about intraopcrativc events (P<0. 05). Conclusions: PHC reduced the incidence of intraopcrativc awareness in patients undergoing breast cancer surgery during general anesthesia.
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