丙泊酚和咪达唑仑用于ICU机械通气患者镇静的临床观察

Sedation Treatment of Propofol and Midazolam on Patients with Mechanical Ventilation in Intensive Care Unit

目的研究丙泊酚和咪达唑仑用于重症监护病房机械通气患者镇静治疗的量效、时效特性,及它们对患者心率、血压的影响。方法随机抽取在ICU机械通气中进行过镇静治疗的50例病例的临床资料,丙泊酚治疗组和咪达唑仑治疗组各25例,回顾分析两组病例临床资料,比较两组病例镇静治疗起效时间和苏醒时间的异同。另外总结两组病例在镇静治疗前和给药10min后心率和血压的变化。结果丙泊酚组镇静治疗起效时间和苏醒时间均明显短于咪达唑仑组。丙泊酚组给药10min后心率、动脉收缩压和舒张压均明显下降。咪达唑仑组给药10min后心率、动脉血压均无明显变化。结论在ICU机械通气患者的镇静治疗中,丙泊酚起效时间和苏醒时间明显短于咪达唑仑,丙泊酚能明显降低心率、动脉收缩压和舒张压,因此,在治疗过程中应根据药物特性和患者的具体状况合理选择镇静治疗方案。

Objective To study the characteristics of quantity-effect,time-effect of propofol and midazolam on patients with mechanical ventilation in intensive care unit,as well as their influences on heart rate and blood pressure.Methods A clinical retrospective analysis being carried out in 50 cases,which have had mechanical ventilation and were sedated by propofol and midazolam.Propofol group and midazolam group had 25 cases respectively.Comparing the onset times to take effect and awakening times of the two groups,then summarizing the changes of heart rate and blood pressure of the two groups.Results The onset time to take effect and awakening time in propofol group are obviously less than that in midazolam group.In propofol group,after administered propofol for 10 minutes,heart rate,systolic arterial pressure and diastolic pressure of patients drop obviously,but no changes in midazolam group.Conclusion In sedation treatment of patients with mechanical ventilation in ICU,propofol need less onset time to take effect and awakening time,but propofol can result in dropping of heart rate and blood pressure,so we should optimize therapeutic regimen,which is based on the characteristics of sedatives and conditions of patients.