早期给予右美托咪定对重症监护酒精戒断综合征患者苯二氮 类药物需求量的影响

Effects of Early Administration of Dexmedetomidine on Benzodiazepine Requirements of ICU Patients with Alcohol Withdrawal Syndrome

目的:评估右美托咪定的早期给予对重症监护酒精戒断综合征患者苯二氮 类药物需求的影响。方法:重度酒精戒断综合征成年患者60例,随机分成A、B两组,每组30例。A组接受苯二氮 类药物的同时早期给予右美托咪定,B组只接受常规苯二氮 类药物治疗。记录患者第一次注射右美托咪定后24 h对苯二氮 类药物的累计需求量、ICU和住院时间、机械通气情况、低血压和心率过缓发生率等。结果:A组患者注射后24 h对苯二氮 类药物的需求明显低于B组[(8.6±1.2)mg vs(25.6±4.9)mg,P<0.05]。两组患者使用机械通气的例数相近,但A组患者插管持续时间明显低于B组[(24.9±3.1)h vs(48.8±6.9)h,P<0.05]。A组患者相对于B组表现出更高的心动过缓发生率(57%vs 13%,P<0.05)。结论:作为治疗戒酒综合征的辅助用药,早期给予右美托咪定可显著降低ICU患者对苯二氮 类药物的需求。

Objective：To evaluate the effects of early administration of dexmedetomidine on benzodiazepine （ BZD） requirements of intensive care unit （ ICU） patients with alcohol withdrawal syndrome （ AWS） .Methods：Totally 60 adult patients with severe AWS were chosen and randomly divided into groups A and group B with 30 patients in each .The patients in group A received benzodiazepine simultaneously with early administration of dexmedetomidine , and those in group B received only benzodiazepine .After the first admin-istration of dexmedetomidine , the 24-h cumulative BZD requirement , stay length in ICU and hospital , condition of mechanical ventila-tion and incidence of hypotension and bradycardia were recorded .Results：The 24-h cumulative BZD requirement in group A was obvi-ously lower than that in group B [（8.6 ·1.2） mg vs （25.6 ±4.9） mg, P〈0.05].The number of patients with mechanical ventila-tion in the two groups was similar, while the duration of intubation in group A was less than that in group B [（24.9 3.1） h vs （48.8 6.9） h, P〈0.05].Additionally, group A had higher incidence of bradycardia when compared with group B （57% vs 13%, P〈0.05）.Conclusion：As the adjuvant treatment for alcohol withdrawal syndrome , early administration of dexmedetomidine can notably decrease the benzodiazepine requirement of ICU patients .