Atomized ultrafine particle size pentylenethyclidine hydrochloride for patients with airway injury after laryngeal mask general anesthesia who take EBUS-TBNA
Objective To observe the effect of aerosol inhalation of ultrafine particle size pentylenethyclidine hydrochloride(PHC)on airway injury in patients after laryngeal mask general anesthesia who take endobronchial ultrasound-guided needle aspiration(EBUS-TBNA),and to analyze its mechanism of action.Methods One hundred and twenty-six patients who took EBUS-TBNA at Henan Provincial People's Hospital from January 2021 to January 2022 were selected for the randomized controlled trial,and were divided into an observation group and a control group by the random number table method,with 63 cases in each group.There were 33 males and 30 females in the observation group;they were 38-72(55.62±5.69)years old.There were 32 males and 31 females in the control group;they were 40-70(56.33±5.25)years old.The observation group received nebulized inhalation of ultrafine particle size PHC as the auxiliary laryngeal mask general anesthesia.The control group received dihydroxypropaphylline injection as the auxiliary laryngeal mask general anesthesia.The inflammatory indicators,airway morphological indicators,and changes in ventilation function before and after the surgery and occurrences of postoperative airway injury were compared between the two groups.t and x2 tests were used.Results After the surgery,the levels of interleukin-13(IL-13),tumor necrosis factor-α(TNF-α),and fractional exhaled nitric oxide(FeNO)in the observation group were lower than those in the control group[(6.13±2.21)ng/L vs.(8.33±2.45)ng/L,(7.22±2.15)ng/L vs.(9.36±2.77)ng/L,and(23.32±2.17)ppb vs.(26.61± 5.41)ppb],with statistical differences(t=5.29,4.84,and 4.48;all P＜0.05).After the surgery,the bronchial basement membrane perimeter(Pbm),total thickness of airway wall,and thickness of airway smooth muscle in the observation group were lower than those in the control group[(1.77±0.24)cm vs(2.16±0.38)cm,(7.15±2.41)mm2/mm vs(9.24±2.25)mm2/mm,and(3.44±0.58)mm2/mm vs(4.41± 1.27)mm2/mm],with statistical differences(t=6.89,5.03,and 5.52;all P＜0.05).The forced expiratory volume in the first second,peak expiratory flow(PEF),and forced vital capacity(FVC)in the observation group were higher than those in the control group[(85.22±10.46)％vs.(78.25± 10.13)％,(422.74±80.61)L/min vs.(378.25±80.24)L/min,and(2.68±0.46)L vs.(1.92±0.74)L],with statistical differences(t=3.80,3.11,and 6.92;all P＜0.05).After the surgery,the incidence of airway injury in the observation group was lower than that in the control group[9.52％(6/63)vs.20.63％(13/63)],with a statistical difference(x2=4.82,P＜0.05).Conclusions Nebulized inhalation of ultrafine particle size PHC assisted laryngeal mask general anesthesia can effectively improve postoperative airway inflammation and ventilation function in patients who take EBUS-TBNA.The mechanism is related to inhibiting airway smooth muscle proliferation and promoting airway morphological recovery.
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