右美托咪啶在内科重症监护病房气道管理中的应用

Application of Dexmedetomidine for the airway management in ICU

目的研究右美托咪啶在内科重症监护病房气道管理的镇静效果。方法随机将需要气道管理镇静的患者分为两组，右美托咪啶组14例、咪达唑仑组25例。咪达唑仑组静脉注射咪达唑仑0．05mg·kg-1负荷量，再以0．05～0．15mg·kg-1·h-1持续静脉泵入；DEX组给予负荷量1．0μg·kg-1，之后注射泵0．2～0．7μg·k-1·h-1持续静脉泵入。以Ramsay分级，维持镇静深度Ⅲ-Ⅳ级，比较观察两组患者镇静前、镇静后心率、平均动脉压、呼吸频率。结果咪达唑仑组的心率、血压和呼吸较镇静前有显著性下降（P〈0．05），而右美托咪啶组对心率、血压、呼吸有影响，但和镇静前比较无显著性差异。结论右美托咪啶可应用于内科莺症监护病房气道管理的镇静治疗。

Objective To examine the sedation effect of dexmedetomidine on ICU patients who demand the airway management. Methods Thirty-nine ICU patients demanding airway management were randomly divided into two groups, dexmedetomidine group of 14 and midazolam group of 25. The dexmedetomidine group was given intravenous injection of dexmedetomidine with an initial dose of 1.0μg·kg-1, followed by pumping a 0.2～0.7μg·k-1·h-1 injection. The midazolam group was given intravenous injection of midazolam with an initial dose of 0.05 mg. kg-1 followed by pumping a 0.05-0.15 mg. kg-1·h-1 injection. According to Ramsay sedation level Ⅲ-Ⅳ, HR, MAP, and RR were compared before and after sedation performed. Results The comparison indicated the HR, MAP, and RR of the patients in midazolam group decreased significantly after sedation performed （P〈0.05）, but no insignificant drop in dexmedetomidine group. Conclusion Dexmedetomidine is considered effective the patients who demand airway management in ICU.