异丙酚联合瑞芬太尼对ICU机械通气患者的镇静作用

Sedation of Propofol Combinded Remifentanil in ICU Patients with Mechanical Ventilation

目的:观察异丙酚联合瑞芬太尼对ICU机械通气患者的镇静作用。方法:100例机械通气ICU患者随机均分为异丙酚组和联合用药组(n=50)。两组患者机械通气期间持续静脉泵注异丙酚1~4 mg/(kg.h),联合用药组加用瑞芬太尼4μg/(kg.h)。分别记录两组患者用药前、用药后5 min、1、6、12、24 h以及气管内吸痰操作前后的收缩压(SBP)、舒张压(DBP)、心率(HR)、异丙酚用量和恶心呕吐发生率。结果:与用药前比较,两组患者用药后各时间点SBP,DBP,HR均下降,但异丙酚组更明显(P(0.05);联合用药组异丙酚用量、低血压、高血压和心动过速发生率明显低于异丙酚组,心动过缓发生率高于异丙酚组(P(0.05),两组间恶心呕吐发生率无差异组(P>0.05)。结论:异丙酚伍用瑞芬太尼用于ICU机械通气患者,镇静效果好,循环动力学稳定,并发症少。

Objective To observe the sedation of propofol combinded with remifentanil in ICU patients undergoing mechanical ventilation.Methods Total 100 patients undergoing mechanical ventlation in ICU were randomly devided into propofol group(group P,n=50) and combined group(group C,n=50).All patients were given propofol(1~4 mg/kg·h) with continous intravenous pumping,while remifentanil was given with a dosage of 4 μg/kg·h in group C additionally.The indexes of systolic pressure(SBP),diastolic pressure(DBP),heart rate(HR),total quantity of propofol consumption,the rates of nausea and vomiting were recorded at pretreatment,and 5min,1 h,6 h,12 h,24 h after administration,respectively.Results Compared with before administration,SBP,DBP,HR were decreased at each time points after administration in two groups,and the decreased degree was more obviously in group P(P﹤0.05).The consumption of propofol,the occurrent rates of hypertension,hypotension,tachycardia in group C were all significantly lower than those of group P,but the bradycardia rate of group C was significantly higher than that of group P(all P﹤0.05),the rates of nausea and vomiting had no significant difference between two groups.Conclusion Propofol combined remifentnail could be safety used for ICU patients undergoing mechanical ventilation with its stability sedation,less complication.