两种镇痛药用于重症监护室术后机械通气患者的疗效探讨

目的：评估两种镇静药物右旋美托咪啶和咪达唑仑分别用于ICU机械通气患者的镇痛疗效。方法：选取2014年6月～2015年6月我院ICU收治的术后机械通气患者75例，根据随机抽样原则将入组患者分成观察组38例和对照组37例。观察组采用右旋美托咪啶持续静脉泵注镇痛，对照组采用咪达唑仑持续静脉泵注镇痛。记录两组镇痛起效时间、唤醒时间、镇静-躁动评分、机械通气时长、临时应用镇痛药次数、住院时长。此外，记录患者出现的不良反应。结果：两组患者镇痛起效时间、镇静-躁动评分、机械通气时长对比差异无统计学意义（P>0.05）；观察组麻醉唤醒时间、ICU住院时长显著短于对照组（P<0.05），镇静过程中临时应用镇痛药的次数显著少于对照组（P<0.05）；观察组镇静后心动过缓、谵妄、呼吸抑制发生率显著低于对照组（P<0.05）。结论：应用右旋美托咪啶对ICU中行机械通气的患者进行镇痛，有效性和安全性较高，可临床推广。

A comparison of dexmedetomidine versus midazolam for patients treated with mechanical ventilation requiring postoperative sedation in ICU

Objective:To evaluate the use of calcium sulfate as a hemostatic agent after tooth extraction in patients with anticoagulant drug therapy. Methods: 75 patients treated with mechanical ventilation, needing postoperative sedation, were selected in ICU during June 2014 to June 2015 for this study. Depending on the drug used for sedation, the patients were divided into two groups: Patients in observation group (38) had been administered dexmedetomidine, and patients in control group (37) had been administered midazolam. The following data were collected: Onset time of sedation, the time of awakening, Sedation-Agitation Scale (SAS), mechanical ventilation time, supplement sedative/analgesic drugs administered in the ICU, the duration of ICU stay and incidence of adverse effects. Results: The onset time of sedation, Sedation-Agitation Scale (SAS) and mechanical ventilation time were similar in two groups of patients (P>0.05). Compared with the midazolam group, the time of awakening and the duration of ICU stay was significantly shorter in the dexmedetomidine group(P<0.05), and the supplement sedative/analgesic drugs administered in the ICU was significantly less in the dexmedetomidine group (P<0.05). Moreover, the incidence of adverse effects in observation group was significant lower than in control group (P<0.05). Conclusion: Dexmedetomidine is a safe and effective agent in treating the patients treated with mechanical ventilation requiring postoperative sedation in ICU, and worthwhile for spreading in clinical practice.