右美托咪定联合瑞芬太尼对ICU颅脑外伤患者镇痛镇静的效果

Effect of dexmedetomidine combined with remifentanil on analgesia and sedation in ICU patients with craniocerebral trauma

目的探讨右美托咪定联合瑞芬太尼用于ICU颅脑外伤患者镇痛镇静的效果。方法选取ICU收治的60例颅脑外伤患者作为研究对象,采用随机分配法将其划分为研究组与对照组,对照组采用咪达唑仑联合瑞芬太尼镇痛镇静,研究组采用右美托咪定联合瑞芬太尼镇痛镇静,对比2组治疗前后心率、呼吸频率、Richmond躁动镇静量表(RASS)评分等指标。结果用药前,2组疼痛视觉模拟评分法(VAS)评分、心率、呼吸频率、收缩压比较,差异无统计学意义(P> 0. 05);用药后6 h,2组心率差异无统计学意义(P> 0. 05),但2组收缩压、呼吸频率存在显著差异(P <0. 05);研究组用药后6、12 h的VAS评分显著低于对照组(P <0. 05); 2组间自醒时间、RASS评分等指标差异显著(P <0. 05)。结论右美托咪定联合瑞芬太尼对ICU颅脑外伤患者的镇静效果明显,停药后患者苏醒所用时间更短,对呼吸系统产生的抑制作用更小。

Objective To observe the analgesic and sedative effects of dexmedetomidine combined with remifentanil in ICU patients with craniocerebral trauma.Methods A total of 60 patients with craniocerebral trauma admitted to ICU in our hospital were divided into study group and control group by random distribution method.The control group was given midazolam plus ruifentanyl for analgesia and sedation,while the study group was given dexmedetomidine combined with ruifentanyl.The heart rate,respiratory rate and Richmond Agitation Sedation Scale(RASS)scores of the two groups before and after treatment were compared.Results There were no statistical difference in Visual Analogue Scores(VAS)scores,heart rate,respiratory rate and systolic blood pressure between the two groups before medication(P>0.05).There was no statistical difference in heart rate at 6 h after the medication between two groups(P>0.05),but systolic blood pressure and respiratory frequency at 6 h after treatment showed significant difference(P<0.05).The scores of VAS at 6,12 h in the study group were lower than that in the control group(P<0.05).There were statistically significant differences between the study group and the control group in self-awakening time and RASS sedation score(P<0.05).Conclusion Dexmedetomidine combined with ruifentanyl in ICU patients with craniocerebral injury has obvious sedative effect,which can shorten waking time,alleviate the inhibitory effect on the respiratory system.