瑞芬太尼联合咪达唑仑对ICU气管插管患者的镇痛镇静效果

Efficacy of remifentanil combined with midazolam on analgesia and sedation in ICU patients with tracheal intubation

目的探讨瑞芬太尼联合咪达唑仑对ICU气管插管患者的镇痛镇静效果。方法选取2019年1月至2021年12月于南昌大学第二附属医院接受气管插管的88例重症患者作为研究对象,采用随机数字表法分为研究组与对照组,每组44例。研究组给予瑞芬太尼联合咪达唑仑镇痛镇静,对照组给予瑞芬太尼镇痛镇静,比较两组给药前后不同时间点收缩压(SBP)、血氧饱和度(SaO_(2))、数字疼痛量表(NRS)评分、呼吸频率及镇静效果。结果两组呼吸频率、SBP、SaO_(2)组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:研究组给药后15 min(T1)、给药后30 min(T2)时SBP均低于T0,T2时呼吸频率低于T0、T1,差异有统计学意义(P<0.05),其他时点各指标两两比较差异无统计学意义;对照组T1、T2时呼吸频率、SBP、SaO_(2)均低于T0,且T2时SBP、SaO_(2)均低于T1,差异有统计学意义(P<0.05),其他时点各指标两两比较差异无统计学意义。组间比较:T0时,两组呼吸频率、SBP、SaO_(2)比较差异无统计学意义;T1时,研究组SaO_(2)高于对照组,差异有统计学意义(P<0.05),两组呼吸频率、SBP比较差异无统计学意义;T2时,研究组呼吸频率、SBP、SaO_(2)均高于对照组,差异有统计学意义(P<0.05)。两组NRS评分组间、时间、交互比较差异有统计学意义(P<0.05);两组给药后各时间点NRS评分均低于前一时间点,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组镇静效果优于对照组,差异有统计学意义(P<0.05)。结论瑞芬太尼联合咪达唑仑镇静镇痛可有效维持ICU插管患者插管期间生命体征稳定,提高镇痛和镇静效果。

Objective To investigate the effect of remifentanil combined with midazolam on analgesia and sedation in ICU patients with tracheal intubation.Methods A total of 88 critically ill patients who received tracheal intubation in the Second Affiliated Hospital of Nanchang University from January 2019 to December 2021 were selected as the research subjects,and they were divided into study group and control group according to random number table method,with 44 cases in each group.The study group was given remifentanil combined with midazolam for analgesia and sedation,and the control group was given remifentanil for analgesia and sedation.The systolic blood pressure(SBP),oxygen saturation(SaO_(2)),digital pain scale(NRS)score,respiratory rate at different time points before and after administration and sedation effect were compared between the two groups.Results There were significant differences in respiratory rate,SBP,SaO_(2)between the two groups of group,time points and interaction(P<0.05).Comparison within the group:at 15 min(T1)and 30 min(T2)after administration,the SBP in the study group was lower than that at T0,and the respiratory rate at T2 was lower than that at T0 and T1,the differences were statistically significant(P<0.05),there were no significant differences in pairwise comparison of each index at other time points;the respiratory rate,SBP and SaO_(2)at T1 and T2 in the control group were lower than those at T0,and SBP and SaO_(2)at T2 were lower than those at T1,the differences were statistically significant(P<0.05),there were no significant differences in each index at other time points.Comparison between groups:at T0,there were no significant differences in respiratory rate,SBP and SaO_(2)between the two groups;at T1,SaO_(2)in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05),there were no significant differences in respiratory rate and SBP between the two groups;at T2,the respiratory rate,SBP and SaO_(2)in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in NRS scores between the two groups of group,time points and interaction(P<0.05).The NRS scores of the two groups at each time point after administration were lower than those at the previous time point,and the study group was lower than the control group,the differences were statistically significant(P<0.05).The sedative effect of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Remifentanil combined with midazolam sedation and analgesia can effectively maintain the stability of vital signs during intubation in ICU patients,and improve the analgesic and sedative effects.