右美托咪定用于ICU术后机械通气患者镇静镇痛的临床观察

目的探讨应用右美托咪定在ICU术后机械通气患者的镇静镇痛的效果观察,并与咪达唑仑组进行对照比较。方法选择2012年5月-2013年7月清远市人民医院收治的麻醉术后转ICU需继续机械通气的患者80例,随机均分为两组,分别应用右美托咪定与咪达唑仑,比较两组患者镇静镇痛评分、撤机时间、拔管时间、机械通气时间及ICU住院时间的差异。结果镇静满意程度右美托咪定组明显高于对照组（80.2%vs 36.5%）（P〈0.05）;右美托咪定组与对照组氧合指数差异无统计学意义（P〉0.05）。右美托咪定组撤机所需时间（59.20±6.55）min vs（60.47±8.67）min,及停药后拔管所需时间（103.40±8.56）min vs（117.30±13.25）min,均少于咪达唑仑组（P〈0.05）。右美托咪定组患者机械通气时间（5.80±1.64）h vs（5.50±1.54）h及ICU住院时间（3.28±0.54）d vs（4.12±0.47）d比较,差异无统计学意义（P〉0.05）。结论与咪达唑仑相比,右美托咪定同时具有镇静和镇痛作用,不仅可安全应用于ICU术后机械通气患者,还能缩短撤机和拔管时间。

The sedative and analgesic effects of dexmedetomidine in ICU patients that underwent postoperative mechanical ventilation

Objective ] To explore the sedative and analgesic effects of dexmedetomidine in ICU patients that underwent panents mat unuerwent postoperative mechanical ventilation by comparing with midazolam. Methods ] 80 post-anesthesia patients that were transferred to the ICU and needed postoperative mechanical ventilation were included in the investigation and the effects of dexmedetomidine were analyzed by using midazolam as the control. The differences between the two groups regarding sedation and analgesia score, mechanical ventilation removal time, extubation time, period of mechanical ventilation and length of stay in ICU were compared. Results ] The sedation satisfaction rate for the dexmedetomidine group （80.2% vs 36.5%） was higher than that for the control group （P〈0.05）, but the difference in oxygenation index was not statistically significant. The dexmedetomidine group enjoyed shorter length of time for mechanical ventilation removal （59.20 ± 6.55）min vs （60.47 ± 8.67） rain or extubation after discontinuation （103.40 ± 8.56）min vs （117.30 ± 13.25）min compared with the control group （P〈0.05）. But the differences in period of mechanical ventilation （5.80 ± 1.64）h vs （5.50 ± 1.54）h and length of stay in ICU （3.28 ± 0.54）d vs （4.12 ± 0.47）d were not statistically significant （P〉0.05）. Conclusion ] Dexmedetomidine has sedative and analgesic activities and is safe for the patients that required postoperative mechanical ventilation in ICU. Besides, dexmedetomidine enjoys shorter length of time for mechanical ventilation removal or extubation after discontinuation.