右美托咪定镇静对机械通气患者记忆和情绪的影响

Influences of Dexmedetomidine on Recall and Emotion of Patients with Mechanical Ventilation

目的评估使用右美托咪定镇静对机械通气患者记忆和情绪的影响。方法采用随机对照研究,将32例ICU气管插管机械通气的患者随机分为两组,分别应用右美托咪定和咪达唑仑镇静,分别采用ICU不适经历记忆调查问卷和医院焦虑抑郁量表评估患者ICU记忆和焦虑抑郁情绪,并观察两组患者机械通气时间、ICU住院时间以及谵妄的发生率。结果右美托咪定组患者有记忆的ICU不适经历事件数目的中位数显著大于咪达唑仑组,差异有统计学意义(P<0.05),两组患者医院焦虑抑郁量表评分结果差异无统计学意义(P>0.05),右美托咪定组机械通气时间较咪达唑仑组缩短,两组患者ICU留住时间相似,右美托咪定组谵妄的发生率更低。结论右美托咪定可增强患者对ICU不适经历的记忆,但未增加焦虑、抑郁情绪的发生,未对临床预后产生不良影响。

Objective To assese recall and emotion of patients with mechanical ventilation after dexmedetomidine seda-tion. Methods The randomized controlled trial was conducted. Thirty-two patients with mechanical ventilation were randomly di-vided into Dexmedetomidine and Midazolam for sedation. The intensive care unit（ ICU） Stressful Experiences Questionnaire,Hospi-tal Anxiety and Depression Scale were administered to assess recall,anxiety and depression. The length of mechanical ventilation, the length of ICU and the incidence of delirium were observed. Results The median number of experiences remembered by dexmedetomidine patients was greater than that of midazolam patients. Manifestations of anxiety and depression were similar be-tween the groups. The length of mechanical ventilation of dexmedetomidine group were shorter than that of midazolam group. The length of ICU of two groups was similar. The incidence of delirium of dexmedetomidine group was lower than that of midazolam. Conclusion Patients received dexmedetomidine were associated with greater recall of ICU experiences,but were no more likely to develop traits of anxiety or depression. Dexmedetomidine was not found to have adverse effects on clinical outcomes.