Penehyclidine mitigates intraoperative oculocardiac reflex and postoperative nausea and vomiting in the patients with strabismus surgery: a prospective, randomized, double-blinded comparison
Background
PONV is one of the most frequent complications following anesthesia and strabismus surgery. Penehyclidine, an anticholinergic, is widely and preoperatively used for reducing glandular secretion in patients. This study investigated the effect of penehyclidine on PONV in strabismus surgery.
Methods
In this prospective, randomized, and double-blinded study, patients of strabismus surgery under general anesthesia were randomly assigned to either penehyclidine (n = 114) or normal saline (NS, n = 104) groups. Penehyclidine was administrated immediately after anesthesia induction, and patients treated with NS served as controls. PONV was investigated within 48 h after surgery. Intraoperative OCR was also recorded.
Results
Compared with NS controls, penehyclidine significantly reduced PONV incidence [30.7% vs. 54.8%, P < 0.001] and mitigated PONV severity as indicated by severity scoring (P < 0.001). When stratified by gender and age, the reduction of PONV incidence following penehyclidine treatment was found significant in all adult patients and male underaged patients. Unexpectedly, penehyclidine also significantly reduced OCR incidence [57.9% vs. 77.9%, P < 0.01] and mitigated OCR severity which indicated by requirement of atropine to rescue [77.3% vs. 90.1%, P < 0.05]. Moreover, penehyclidine did not significantly change anesthesia recovery time, facial flushing and drowsiness occurrence compared to NS controls.
Conclusions
Penehyclidine administration after anesthesia induction significantly attenuated intraoperative OCR and PONV in strabismus surgery patients.
Trial registration
ClinicalTrials.gov (NCT04054479). Registered July 19, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04054479?id=NCT04054479&draw=2&rank=1
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Posted 28 Sep, 2020
Received 27 Dec, 2020
On 27 Dec, 2020
On 10 Dec, 2020
Received 23 Oct, 2020
On 07 Oct, 2020
Invitations sent on 29 Sep, 2020
On 15 Sep, 2020
On 14 Sep, 2020
On 14 Sep, 2020
Penehyclidine mitigates intraoperative oculocardiac reflex and postoperative nausea and vomiting in the patients with strabismus surgery: a prospective, randomized, double-blinded comparison
Posted 28 Sep, 2020
Received 27 Dec, 2020
On 27 Dec, 2020
On 10 Dec, 2020
Received 23 Oct, 2020
On 07 Oct, 2020
Invitations sent on 29 Sep, 2020
On 15 Sep, 2020
On 14 Sep, 2020
On 14 Sep, 2020
Background
PONV is one of the most frequent complications following anesthesia and strabismus surgery. Penehyclidine, an anticholinergic, is widely and preoperatively used for reducing glandular secretion in patients. This study investigated the effect of penehyclidine on PONV in strabismus surgery.
Methods
In this prospective, randomized, and double-blinded study, patients of strabismus surgery under general anesthesia were randomly assigned to either penehyclidine (n = 114) or normal saline (NS, n = 104) groups. Penehyclidine was administrated immediately after anesthesia induction, and patients treated with NS served as controls. PONV was investigated within 48 h after surgery. Intraoperative OCR was also recorded.
Results
Compared with NS controls, penehyclidine significantly reduced PONV incidence [30.7% vs. 54.8%, P < 0.001] and mitigated PONV severity as indicated by severity scoring (P < 0.001). When stratified by gender and age, the reduction of PONV incidence following penehyclidine treatment was found significant in all adult patients and male underaged patients. Unexpectedly, penehyclidine also significantly reduced OCR incidence [57.9% vs. 77.9%, P < 0.01] and mitigated OCR severity which indicated by requirement of atropine to rescue [77.3% vs. 90.1%, P < 0.05]. Moreover, penehyclidine did not significantly change anesthesia recovery time, facial flushing and drowsiness occurrence compared to NS controls.
Conclusions
Penehyclidine administration after anesthesia induction significantly attenuated intraoperative OCR and PONV in strabismus surgery patients.
Trial registration
ClinicalTrials.gov (NCT04054479). Registered July 19, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04054479?id=NCT04054479&draw=2&rank=1
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5