右美托咪定联合舒芬太尼对ICU患者镇静镇痛效果研究

目的探析ICU患者应用右美托咪定与舒芬太尼联合法对其镇静镇痛作用的效果。方法选择河北北方学院附属第一医院2013年1～12月ICU术后患者90例为观察对象,按术后镇痛用药不同分为A、B、C组,每组各30例。A组术后予以静注舒芬太尼1.0μg/kg,B组术后静注舒芬太尼1.5μg/kg,C组术后静注右美托咪定2.0μg/kg＋舒芬太尼1.0μg/kg,比较3组患者术后镇静镇痛效果及不良反应。结果 C组术后6、12、24 h活动痛、静息痛评分情况显著优于A、B组,差异有高度统计学意义（P〈0.01）,A组与B组比较差异无统计学意义（P〉0.05）。C组术后6、12、24 h的Ramsay评分情况显著优于A、B组,差异有高度统计学意义（P〈0.01）,A组与B组比较差异无统计学意义（P〉0.05）。C组不良反应发生率（16.7%）显著低于A、B两组（63.3%、60.0%）,差异有统计学意义（P〈0.05）,A、B组比较差异无统计学意义（P〉0.05）。结论 ICU患者术后应用右美托咪定联合舒芬太尼联合疗法,镇静镇痛作用效果确切,可靠安全,值得临床推广。

Sedation and analgesia effects of Dexmedetomidine combined with Sufentanil for patients with ICU

Objective To study the effect of sedation and analgesia of Dexmedetomidinel combined with Sufentanil for patients with ICU. Methods 90 cases of ICU patients with operation in the First Affiliated Hospital of Hebei North University from January to December 2013 were selected and divided into group A, group B and group C with 30 cases in each group according to the postoperative different analgesic medication. Group A was given intravenous Sufentanil1.0 μg/kg, group B was given intravenous Sufentanil 1.5 μg/kg, group C was given static Dexmedetomidine 2.0 μg/kg＋Sufentanil 1.0 μg/kg. The effect of sedation and analgesia and adverse reaction after operation were compared among3 groups. Results The activities and rest pain score postoperative 6, 12, 24 hours in group C were all better than those in group A and group B, the differences were statistically significant（P〈0.01）, the differences of activities and rest pain score between group A and group B was not statistically significant（P〉0.05）. Ramsay score of group C 6, 12, 24 hours after the operation were better than those of group A and group B, the differences were statistically significant（P〈0.01）, the differences of Ramsay score between group A and group B was not statistically significant（P〉0.05）. The incidence of adverse reaction in group C（16.7%） was lower than that in group A and group B（63.3%, 60.0%）, the differences were statistically significant（P〈 0.05）, the differences of adverse reaction incidence between group A and group B was not statistically significant（P〉0.05）. Conclusion The application of Dexmedetomidine combined with Sufentanil ICU in patients with ICU has exact sedative and analgesic effect, reliability and safety, it is worthy of clinical promotion.