摘要
目的探讨右美托咪定(Dex)复合布托啡诺应用于重症监护单元(ICU)患者持续镇静的效果.方法选取ICU患者82例,按照随机数表法分为观察组与对照组各41例.对照组给予Dex复合芬太尼,观察组给予Dex复合布托啡诺.比较两组给药前后血流动力学指标变化,分析两组催眠深度[脑电双频指数(BIS)]、镇静程度(Ramsay镇静评分)、给药相关指标、谵妄发生情况[ICU意识模糊评估法(CAM-ICU)]及其他药物不良反应发生情况差异.结果给药后,两组血流动力学指标均较给药前有显著降低(P<0.05),但组间降低幅度相当(P>0.05).给药后48h时,两组BIS、Ramsay镇静评分、CAM-ICU谵妄阳性率及呼吸抑制、低血压、心动过缓发生率比较差异均无统计学意义(P>0.05),观察组药效达标时间、停止给药后意识恢复时间、停止给药后拔管时间、48h内丙泊酚使用剂量、住ICU时间及严重呛咳、恶心/呕吐发生率均明显少于对照组,差异均有统计学意义(P<0.05).结论Dex复合布托啡诺可确保ICU患者持续镇静、维持血流动力学稳定的同时,还可降低谵妄发生率,药物安全性亦较为理想,对其预后康复有利.
Objective To explore the clinical effects of dexmedetomidme(Rex)combined with butoiphanol in continuous sedation of patients,in intensive care unit(1CU)Methods Eighty-two patients with ICU were selected for the study.According to the random number table method,the patients were disided into observation group and control group,with 41 cases in each group.Control group was given Rex combined with fetuanyl,and observation group was given Rex combined with butorphanol.The changes of hemodynamic parameters were compared between the two groups before and after administration,and the hypnotic depth bisprctral index(BIS)I,sedation degree(Ramsay sedation score),drug administration-related indicators and oreurrenre of delirium Confusion Assessment Method for The Intensive Care Unit(CAM-ICU)and occurrence of other adverse drug reactions were analyzed in the two groups Results After administration,the hemodynamic parameters in the two groups were significantly decreased compared with those before administration(P<0.05),but the reduction between groups was equivalent(P>0.05).At 48h after administration,there were no significant differences in the BIS,Ramsay sedation score,positive rate of CAM-ICU delirium and incidence rates of respiratory depression,hypotension and bradycardia between the two groups(P>0.05).The standard time of drug efficacy,consciousness recovery time after cessation of administration,extubation time after cessation of administration,propofol dosage within 48h,ICU stay and incidence rates of severe bucking and nausea/vomiting in observation group were significantly lower than those m control group(P<005).Conclusion Rex combined with butorphanol can ensure the continuous sedation of ICU patients,maintain hemodynamic stability and reduce the incidence rate of delirium,and it has ideal drug safety,and it is beneficial to the prognosis and rehabilitation.
出处
《浙江临床医学》
2020年第7期1036-1038,共3页
Zhejiang Clinical Medical Journal
基金
浙江省温州市科技局项目(Y20170742)。
