夜间应用咪唑安定对ICU患者皮质醇的影响

Effect of Midazolam Administered Overnight on Patience's Cortisol in ICU

目的研究咪唑安定镇静对ICU患者夜间皮质醇的影响。方法采用自身对照,选择APACHE-Ⅲ评分<60、入室3 d以上患者10例,与入室24 h病情平稳后患者,在相邻2 d中随机选择1夜里给予咪唑安定辅助睡眠,为镇静组;而另1 d为自主睡眠者,为非镇静组。监测20:00至次日6:00时段内睡眠时间,Brussels镇静评分、BIS、SBP、DBP、HR、RR、SpO2等项指标,每15 min记录1次。分别在20:00、24:00和次日6:00采血1.5 mL,测皮质醇。结果24:00时皮质醇血浆含量镇静组低于非镇静组(P<0.05);20:00、次日6:00皮质醇含量两组无明显差异;两组镇静评分、BIS值有显著差异,镇静组明显低于非镇静组(P<0.05);睡眠时间镇静组明显多于非镇静组(P<0.01);生命体征两组无明显差异。结论夜间给予咪唑安定辅助睡眠对患者的循环、呼吸没有显著影响,能降低ICU患者夜间皮质醇含量,增加睡眠时间及深度,提高睡眠质量。

Objective To study the effect of midazolam administered overnight on patients＇ cortisol in ICU. Methods By the auto- control ten patients were chosen who could stay in ICU for over three days and had similar APACHE - Ⅲ value. In consecutive two days after the first 24 h, randonfly one day was administered midazolam overnight to help sleeping, and another day for nothing there were everal markers recorded every 15 min, they were sleeping time, sedation scales, BIS value,SBP, DBP, HR, RR, SpO2 and so on. It is neeessary to draw 1.5 mL blood for testing eortisol at 20：00,24：00 and next 6：00. Results The significant differences were observed in sleeping time, sedation scales and BIS, the sedated group was lower than the non - sedated one; As with the result was the level of serum eortisol at 24： 00, but the other parameters had no difference. Conclusion Low - dose midazolam administered ovenight to ICU patients not only could prolong the time of sleeping, raise quality and depth of sleeping, but also reduce the level of serum, cortisol. While respiration and circulation are not interrupted.