异丙酚和咪唑安定对ICU机械通气镇静治疗效果的比较

Comparison between propofol and midazolam for sedation in treatment of mechanically ventilated patients in ICU

目的比较异丙酚和咪唑安定对重症监护病房(ICU)机械通气患者镇静治疗的效果。方法选择在IC U呼吸机治疗的患者58人,随机分为两组。异丙酚组30人,咪唑安定组28人,异丙酚组以0.25～1.00m g/kg异丙酚行静脉诱导,咪唑安定组以0.05～0.10 mg/kg咪唑安定行静脉诱导,然后改用微量泵持续注入,异丙酚0.50～4.00 m g/(kg.h),咪唑安定0.05～0.15 mg/(kg.h)进行维持,根据不同的R AM SAY镇静分级调整用量,维持理想的镇静深度3、4级,观察两组药物起效时间、停药后苏醒时间,并记录用药前后和苏醒时心率、血压及血氧饱和度,停药后再入睡发生情况。结果两组药物起效时间异丙酚组为(36.0±6.0)s,咪唑安定组为(55.0±8.0)s,两组比较差异有显著性(P<0.01)。停药后苏醒时间异丙酚组为(44.8±7.0)min,咪唑安定组为(92.0±8.0)min(P<0.01)。两组患者随镇静程度的加深用药量增加,但对呼吸循环无明显抑制。异丙酚组较咪唑安定组苏醒时间快,苏醒后再入睡率明显减少(P<0.05)。结论异丙酚镇静起效时间短,苏醒快,苏醒后不良反应发生率明显少于咪唑安定。

【Objective】 To observe propofol and sulfonated stability of intensive care unit（ICU） care unit,on the treatment of patients with mechanical ventilation sedation.【Methods】 58 patients treated in the ICU breathing machines were randomly divided into two groups.In the propofol group of 30 cases,imidazole group 28cases,the propofol group was given 0.25~1.00 mg/kg propofol,imidazole group was given 0.05 ~ 0.1 imidazole mg/kg,using intravenous infusion pump,then switched to trace induced sustained injection,according to the different classification,adjusted dosage,Ramsay calm maintained ideal calm deep level 3~4,two groups of drug effect-acting period,after withdrawal,and recorded the waking therapy and heart rate,blood pressure and pulse oximetry saturation,after discontinuation sleep occurs.【Results】 The onset time to take effect in propofol group was（36.0±6.0）seconds,and（55.0±8.0）seconds in midazolam group,showing significant difference（P 0.01）.The time to be awaken after stopping drug was（44.8±7.0） minutes in propofol group and（92±8.0） minutes in midazolam group（P 0.01）.Cases that fell asleep again after awakening and nausea stopping drug in propofol group was significantly fewer than that of midazolam group（P 0.05）.【Conclusion】 The effect-acting period of propofol is shorter,quicker waking up after adverse reactions than miaow thiazole stability.