盐酸右美托咪定目标浅镇静方案在ICU机械通气患者中的应用及不良反应发生情况

Application of Dexmedetomidine Hydrochloride Target Shallow Sedation Regimen in ICU Patients With Mechanical Ventilation and the Occurrence of Adverse Reactions

目的:探讨盐酸右美托咪定目标浅镇静方案在ICU机械通气患者中的应用价值及不良反应发生情况。方法:选取2019年9月—2021年8月南华附属第二医院ICU收治的99例机械通气患者,采用双盲、随机数字表法分为常规组(n=49)和观察组(n=50)。常规组予以常规镇静方案,观察组予以盐酸右美托咪定目标浅镇静方案,比较两组目标镇静达成率、麻醉指标、认知功能状态以及不良反应情况。结果:两组目标镇静达成率比较,差异无统计学意义(P>0.05)。观察组机械通气时间、浅镇静时间、唤醒时间、ICU住院时间短于常规组,差异有统计学意义(P<0.05)。停药后48 h,两组MMSE评分、心率、平均动脉压比较,差异无统计学意义(P>0.05)。观察组谵妄、躁动的发生率低于常规组差异有统计学意义(P<0.05);而两组其他不良反应发生率比较,差异无统计学意义(P>0.05)。结论:盐酸右美托咪定目标浅镇静方案在ICU机械通气患者中的镇痛镇静作用显著,可缩短患者机械通气时间、唤醒时间、住院时间,降低谵妄、躁动等不良反应发生率,具有应用有效性及安全性。

Objective:To investigate the application value of dexmedetomidine hydrochloride target shallow sedation regimen in ICU patients with mechanical ventilation and the occurrence of adverse reactions.Methods A total of 99 mechanically ventilated patients admitted to the ICU of the Second Nanhua Affiliated Hospital from September 2019 to August 2021 were selected and divided into the routine group(n=49)and the observation group(n=50)using a double-blind,random number table method.The routine group was given a routine sedation plan,and the observation group was given a target shallow sedation plan of dexmedetomidine hydrochloride.The target sedation achievement rate,anesthesia indicators,cognitive function status and adverse reactions were compared between the two groups.Results There was no statistically significant difference in the target sedation achievement rate between the two groups(P>0.05).The observation group’s mechanical ventilation time,light sedation time,wake-up time,and ICU hospital stay were shorter than those of the routine group,and the difference was statistically significant(P<0.05).There was no significant difference in MMSE score,heart rate,and mean arterial pressure between the two groups at 48 hours after stopping the drug(P>0.05).The incidence of delirium and restlessness in the observation group was lower than that in the routine group,and the difference was statistically significant(P<0.05);while the difference in the incidence of other adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion Dexmedetomidine hydrochloride target shallow sedation program has significant analgesic and sedative effects in ICU mechanically ventilated patients,which can shorten the patient’s mechanical ventilation time,wake-up time,and hospital stay,reduce the incidence of delirium,agitation and other adverse reactions,and is effective in application And safety.