咪达唑仑和右美托咪定对老年COPD机械通气患者镇静效果比较

Comparison of Sedative Effects of Midazolam and Dexmedetomidine in Elderly Patients with COPD and Mechanical Ventilation

目的:比较咪达唑仑和右美托咪定对老年慢性阻塞性肺疾病(COPD)机械通气患者镇静效果。方法:选取2016年11月至2018年11月于医院呼吸科及重症监护室就诊的68例老年COPD机械通气患者,并根据镇静方案的不同将其分为A组(给予咪达唑仑镇静)37例、B组(给予右美托咪定镇静)31例;观察两组的机械通气时间、药物起效时间、苏醒时间和使用镇痛药物情况,根据Ramsay镇静评分评估两组的镇静效果。结果:A组经过镇静后,药物起效时间和苏醒时间短于B组(P<0.05),机械通气时间和使用镇痛药物情况比较差异无统计学意义(P>0.05);A组的Ramsay镇静评分和用药24h血氧饱和度低于B组(P<0.05),用药24h心率及平均动脉压均高于B组(P<0.05)。结论:右美托咪定对老年COPD机械通气患者镇静效果更好,有助于增强机械通气的疗效。

Objective: To compare the sedative effects of midazolam and dexmedetomidine in elderly patients with chronic obstructive pulmonary disease(COPD)and mechanical ventilation. Methods: 68 elderly patients with COPD and mechanical ventilation who were admitted to respiratory department and intensive care unit of the hospital from November 2016 to November 2018 were selected. According to the sedation regimens, they were divided into group A(37 cases, midazolam sedation)and groupB(31 cases, dexmedetomidine sedation). Themechanical ventilation time, drug onset time, recovery time and use of analgesic drugswere observed in the two groups. The sedative effects of the two groups were evaluated by Ramsay sedation score. Results: After sedation, the drug onset time and recovery time in group A were shorter than those in groupB(P<0.05). There were no significant differences in the mechanical ventilation time and use of analgesic drugs(P>0.05). Ramsay sedation score and 24 h oxygen saturation in group A were lower than those in groupB(P<0.05), and 24 h heart rate and mean arterial pressure were higher than those in groupB(P<0.05). Conclusions: Dexmedetomidine has better sedative effects in elderly patients with COPD and mechanical ventilation, and it can help to enhance the efficacy of mechanical ventilation.