Objective To study the effect of penehyclidine hydrochloride (PHC) on inflammatory and stress reaction in severe burn patients undergoing early escharectomy and skin grafting. MethodsForty severe burn patients undergoing early escharoctomy and skin graft were randomly divided into two groups of 20 each: penehyclidine hydrochloride group (group P) and control group (group C). Patients in group P were injected with PHC 0.05 mg/kg 10 min before operation. Patients in group C were injected with the same volume of saline. Venous blood was drawn at 5 time points: 10 min before operation (T1), immediately after operation (T2), 8 h after operation(T3), 24 h after operation(T4), and 48 h after operation(T5).The density of blood cytokine levels (IL-6，IL-10，TNF-α) was detected by enzyme-linked immunosorbent assay. Blood samples were taken for analysis of serum glucose and lactate concentration at each time point.ResultsThere was no significant difference in the concentration of blood glucose, lactate and IL-6，IL-10，TNF-α between group P and group C at T1 (P>0.05). In group P, the concentration of blood glucose and lactate was significantly lower at T2-5 than in group C (P＜0.05). In group P, the concentration of IL-6 and TNF-α was significantly lower at T2-5 than that in group C (P＜0.05). There was no significant difference in the concentration of blood IL-10 between the two groups (P>0.05). Conclusions0.05 mg/kg penehyclidine hydrochloride preconditioning before operation can alleviate inflammatory and stress reaction by regulating the nervous system, endocrine system and immunity system.