右美托咪定联合芬太尼对冠心病患者术后镇静镇痛的效果

Effect of Dexmedetomidine Combined with Fentanyl on Postoperative Sedation and Analgesia in Patients with Coronary Heart Disease

目的:探讨右美托咪定联合芬太尼对冠心病患者术后镇静镇痛的效果。方法:选取2017年6月-2019年6月在笔者所在医院就诊的冠心病患者80例,随机分为两组,对照组持续微量泵入咪达唑仑+芬太尼,研究组持续微量泵入右美托咪定+芬太尼。比较两组ICU停留时间、机械通气时间、脉搏血氧饱和度、呼吸频率等情况。结果:研究组ICU停留时间、机械通气时间均短于对照组,差异均有统计学意义(P<0.05);研究组用药后4、12、24 h时脉搏血氧饱和度、呼吸频率与用药前比较差异无统计学意义(P>0.05),且研究组脉搏血氧饱和度、呼吸频率均高于同时间对照组,差异均有统计学意义(P<0.05)。结论:冠心病患者术后使用右美托咪定联合芬太尼具有较好的镇静镇痛效果,虽有轻度心率降低的副作用,但患者自主呼吸无明显抑制,同时显著缩短ICU停留时间及机械通气时间,可保持唤醒能力。

Objective:To investigate the effects of Dexmedetomidine combined with Fentanyl on postoperative sedation and analgesia,mechanical ventilation duration and ICU stay in patients with coronary heart disease.Method:A total of 80 patients with coronary heart disease who were admitted from June 2017 to June 2019 were randomly divided into two groups.Patients in the control group were continuously pumped with trace amounts of Midazolam+Fentanyl,while patients in the study group were continuously pumped with trace amounts of Dexmedetomidine+Fentanyl.The ICU stay time,mechanical ventilation time,pulse oxygen saturation and respiratory frequency were compared between the two groups.Result:The ICU stay time and mechanical ventilation time in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in pulse oxygen saturation and respiratory rate between the study group and the control group at 4,12 and 24 h after administration(P>0.05),and pulse oxygen saturation and respiratory rate in the study group were higher than those in the control group at the same time,the differences were statistically significant(P<0.05).Conclusion:Postoperative use of Dexmedetomidine combined with Fentanyl has a good sedative and analgesic effect in patients with coronary heart disease.Although there is a slight side effect of decreased heart rate,the patients’spontaneous breathing is not significantly inhibited,and the duration of stay in ICU and mechanical ventilation is significantly shortened,thus maintaining the ability to wake up.