舒芬太尼联合咪达唑仑对重症监护室颅脑损伤患者应激反应及RASS评分的影响

Effect of sufentanil combined with midazolam on stress response and RASS score of patients with craniocerebral injury in intensive care unit

目的探讨重症监护室颅脑损伤患者采用舒芬太尼联合咪达唑仑治疗对其应激反应和镇静程度评估表(RASS)评分的影响。方法选取2016年10月至2018年8月本院重症监护室收治的颅脑损伤患者74例,按照随机数表法分为观察组和对照组,每组各37例。对照组采用吗啡联合咪达唑仑镇痛镇静,观察组采用舒芬太尼联合咪达唑仑镇痛镇静,对比两组应激反应、RASS评分及不良反应情况。结果观察组治疗后1 d、3 d及7 d时乳酸及空腹血糖水平均低于对照组(P<0.05);观察组治疗后1 d时RASS评分低于对照组(P<0.05);两组不良反应发生率对比,差异无统计学意义。结论舒芬太尼联合咪达唑仑治疗可有效减轻重症监护室颅脑损伤患者应激反应,提高镇静效果。

Objective To investigate the effect of sufentanil combined with midazolam on stress response and Richmond Agitation-Sedation Scale(RASS) score of patients with craniocerebral injury in intensive care unit. Methods 74 patients with craniocerebral injury in intensive care unit from October 2016 to August 2018 were selected, and they were divided into observation group and control group by random number table, with37 cases in each group. Control group was given sedation and analgesia with morphine and midazolam, while observation group was given sedation and analgesia with sufentanil and midazolam. The stress response, RASS score and adverse reactions were compared between the two groups.Results After treatment for 1 d, 3 d and 7 d, the levels of lactic acid and fasting blood glucose in observation group were lower than those in control group(P<0.05). After treatment for 1 d, the score of RASS in observation group was lower than that in control group(P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups. Conclusion Sufentanil combined with midazolam in treatment of patients with craniocerebral injury in intensive care unit can effectively reduce stress response and increase sedation effects.