右美托咪啶在外科重症监护病房中的镇静镇痛作用

Analysis of Using Dexmedetomidine for Primary Sedation and Analgesic Effect in Surgery Intensive Care Unit

目的:研究右美托咪啶对外科重症患者的镇静、镇痛作用。方法:将本院外科重症监护病房需要镇静、镇痛120例患者按照随机原则分为有美托咪啶组(58例)和咪达唑仑组(62例)。右美托咪啶组经静脉泵入负荷剂量1μg·kg^(-1)、10 min,继以0.2～0.7μg·kg^(-1)·h^(-1)维持;咪达唑仑组给予负荷剂量0.06 mg·kg^(-1),再以0.04～0.20 mg·kg^(-1)·h^(-1)维持。结果:右美托咪啶组视觉模拟法(VAS)评分低于咪达唑仑组[(2.38±0.48)分&(6.07±0.79)分,P<0.01];唤醒所需时间显著短于咪达唑仑组[(0.17±0.03)h &(1.63±0.56)h,P<0.01]。右美托咪啶组出现血压下降3例,自主呼吸频率无明显变化;咪达唑仑组出现血压下降10例,出现自主呼吸频率下降3例(P<0.05)。右美托咪啶组中有6例产生顺行性遗忘,咪达唑仑组所有患者均产生顺行性遗忘(P<0.05)。结论:右美托咪啶是外科重症监护病房较为理想的镇静、镇痛药物。

Objective： To investigate the sedative and analgesic effects of dexmedetomidine in patients with serious surgery diseases. Methods： 120 cases admitted to the surgery intensive care unit needed sedation and analgesia were randomly divided into dexmedetomidine group （n =58） and midazolam group （n =62）. Dexmedetomidine group received dexmedetomidine as a loading dose of 1 μg/kg for 10 rain followed by a maintenance infusion of （0.2-0.7）μg.kg-1.h-1, when midazolam group received midazolam as a loading dose of 0.06 mg/kg followed by a maintenance infusion of （0.04-0.20）mg. kg-1 h-1 Results： The score of visual analog scale in dexmedetomidine group was lower than that in midazolam group（2.38±0.48 VS. 6.07±0.79,P〈0.01）.The awakening time was shorter in dexmedetomidine group than that in midazolam group [（0.17 ±0.03）hours VS. （1.63±0.56）hours,P〈0.01]. Conclusion： Dexmedetomidine is the recommended drug used for sedation and analgesia in surgery intensive care unit.