右美托咪定用于机械通气患者的镇静效果评价

Effect of Dexmedetomidine on Sedation in Patients with Mechanically Ventilated

目的评价右美托咪定用于机械通气患者的镇静效果。方法选取2011年2月—2013年6月在我院MICU住院的机械通气患者51例,将其随机分为咪达唑仑组(n=25,C组)和右美托咪定组(n=26,D组)。C组静脉注射咪达唑仑,D组静脉注射右美托咪定。观察患者镇静前,镇静后10 min、30 min、2 h时的心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO2);记录开始镇静至停药后2 h不良事件的发生情况;记录苏醒时间和苏醒后2 h内再入睡的发生情况。结果 D组谵妄发生率低于C组,苏醒时间短于C组,苏醒后2 h内再入睡率低于C组(P<0.05)。两组患者镇静前,镇静后10 min、30 min、2 h时HR、RR及SpO2比较,差异均无统计学意义(P>0.05)。结论右美托咪定对机械通气患者镇静效果优于咪达唑仑,对呼吸影响相似,对循环影响较小,谵妄发生率低。

Objective To evaluate the effect of dexmedetomidine on sedation in patients with mechanically ventilated. Methods 51 patients supported with mechanical ventilation admitted to our hospital from February 2011 to June 2013 were ran- domly divided into midazolam group （ group C, n = 25 ） and dexmedetomidine group （ group D, n = 26）. Group C was intrave- nously injected with midazolam, group D was intravenously injected with dexmedetomidine. The HR, BP, RR, SpOz were ob- served before sedation, after 10 min, 30 min, 2 hours of sedation. The occurrence of adverse events from sedation to 2 hours af- ter treatment, recovery time and reoccurrence rate of sleep 2 hours after waking were recorded. Results The rate of delirium and reoccurrence of sleep 2 hours after waking in group D were lower than those of group C, recovery time shorter （ P 〈 0. 05 ） ~ The HR, BP, RR, SpO2 before sedation, after 10 rain, 30 min, 2 hours of sedation between two groups showed no significant differences （P 〉 0. 05 ）. Conclusion The sedative efficacy of dexmedetomidine on mechanically ventilated is better than that of midazolam, and has similar efficacy on respiration, less impact on circulation, lower rate of delirium.