title: Effect of penehyclidine hydrochloride on the incidence of intra-operative awareness in Chinese patients undergoing breast cancer surgery during general anaesthesia.
abstract: Intra-operative awareness can lead to serious adverse psychological consequences. We conducted a prospective, randomised, double-blinded trial in 920 patients undergoing breast cancer surgery under bispectral index-guided total intravenous anaesthesia to evaluate the effect of penehyclidine hydrochloride on intra-operative awareness. Patients were randomly divided to receive 0.01 mg.kg(-1)  penehyclidine hydrochloride or saline intravenously 30 min before surgery. The pre-administration, pre-operative anxiety levels were assessed using a 100-mm visual analogue scale. Intra-operative awareness was defined as recall of intra-operative events using a modified Brice interview administered 2-6 h postoperatively, and in the next 24-48 h. A committee of three experts, blinded to the study conditions, independently scrutinised all reported recollections. We found no differences in depth of anaesthesia and patients' pre-operative anxiety levels between the two groups. The incidence of awareness with penehyclidine hydrochloride (0/456 patients; 0%) was significantly lower than with saline (5/452; 1.1%), p = 0.030. We conclude that penehyclidine hydrochloride reduced the incidence of intra-operative awareness in patients undergoing breast cancer surgery during general anaesthesia.
authors.affiliation: Department of Anaesthesiology, Fudan University, Shanghai Cancer Centre, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Ren
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.forename: J W
authors.initials: JW
authors.lastname: Chen
authors.forename: M M
authors.initials: MM
authors.lastname: Zhu
authors.forename: Y J
authors.initials: YJ
authors.lastname: Xu
authors.forename: Z M
authors.initials: ZM
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001943:Breast Neoplasms / Q000601:surgery*; D002681:China / Q000453:epidemiology; D018680:Cholinergic Antagonists / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D058926:Intraoperative Awareness / Q000453:epidemiology*; D008875:Middle Aged; D011446:Prospective Studies; D011812:Quinuclidines / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D018680:Cholinergic Antagonists; D011812:Quinuclidines; C486140:penehyclidine