丙泊酚和瑞芬太尼对术后神清重症患者机械通气镇静和镇痛的研究

目的研究丙泊酚和瑞芬太尼镇静和镇痛对术后神清重症患者机械通气的影响。方法腹部手术患45例，随机分I组（n=15）、II组（n=15）、III组（n=15），选择相同剂量丙泊酚和不同剂量瑞芬太尼进行镇静和镇痛，监测各组患者镇静和镇痛前后呼吸循环参数变化，Ramsay及vAS评分。结果三组呼吸循环参数给药前与给药后30min、给药后60min比较，给药后30min与给药后60min比较有统计学意义（P〈0．05）；三组镇静镇痛参数给药前与给药后30min、给药后60min比较，给药后30min与给药后60min比较有统计学意义（P〈0．05）；给药前与给药后30minVAS与Ramayl组与11组、III组P〈0＋05，给药前与给药后60minVAS与RamayI组与II组P〈0．05，I组与111组P〈0．05，VASII组与III组P〈0．05。结论对术后神清重症机械通气患者使用丙泊酚和瑞芬太尼进行镇静镇痛，在丙泊酚镇静量不变的情况下，瑞芬太尼0．1μg／（kg·min）持续静脉输注镇痛是较适宜的剂量，但可根据患者个体差异在其范围进行调整。

Effects of Propofol and Remifentanil in Sedation and Analgesia on Postoperative Patients with Mechanical Ventilation God Clear Severe Psychosomatic Stress Response

Objective Study of propofol and remifentanil in sedation and analgesia on postoperative god clear effects of mechanical ventilation in patients with severe. Methods Patient of 45 cases of abdominal operation, were randomly divided into group I （n=15）, group II （n=15）, group III （n=15）, select the same arid different doses of remifentanil propofol for sedation and analgesia, cycle parameters before and after each change of respiratory monitoring of sedation and analgesia, Ramsay and VAS score. Results The remaining three groups ＆respiratory and circulatory parameters were administered before and after administration of 30min, 60min after administration, 30min after administration and after administration of 60min was statistically significant （P〈0.05）; the remaining three groups of sedation and analgesia parameters were administered before and after administration of 30rain, 60min after administration, 30min after administration and after administration of 60min was statistically significant （P〈0.05）. Administered before and after administration of 30minVAS and Ramay I and if, Ill group P〈0.05, administered before and after administration of 60minVAS and Ramay I and II group P〈0.05, I and III group P〈0.05, VAS II and III group P〈0.05. Conclusion On postoperative severe patients with mechanical ventilation of God clearly using propofol and remifentanil for sedation and analgesia, sedation of propofol in the same volume of cases, remifentanil 0.11ag/（kg·min） continuous intravenous infusion analgesia is the suitable dose, but according to the individual difference of patients adjusted in the range.