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目的:研究右美托咪啶对外科重症患者的镇静、镇痛作用。方法:将本院外科重症监护病房需要镇静、镇痛120例患者按照随机原则分为有美托咪啶组(58例)和咪达唑仑组(62例)。右美托咪啶组经静脉泵入负荷剂量1μg·kg~(-1)、10 min,继以0.2～0.7μg·kg~(-1)·h~(-1)维持;咪达唑仑组给予负荷剂量0.06 mg·kg~(-1),再以0.04～0.20 mg·kg~(-1)·h~(-1)维持。结果:右美托咪啶组视觉模拟法(VAS)评分低于咪达唑仑组[(2.38±0.48)分&(6.07±0.79)分,P<0.01];唤醒所需时间显著短于咪达唑仑组[(0.17±0.03)h &(1.63±0.56)h,P<0.01]。右美托咪啶组出现血压下降3例,自主呼吸频率无明显变化;咪达唑仑组出现血压下降10例,出现自主呼吸频率下降3例(P<0.05)。右美托咪啶组中有6例产生顺行性遗忘,咪达唑仑组所有患者均产生顺行性遗忘(P<0.05)。结论:右美托咪啶是外科重症监护病房较为理想的镇静、镇痛药物。
Objective: To study the effects of dexmedetomidine on sedation and analgesia in surgical critically ill patients. Methods: One hundred and seventy patients with sedation and analgesia in our surgical surgical intensive care unit were divided into two groups according to randomization: metoprolol group (58 cases) and midazolam group (62 cases). The patients in the dexmedetomidine group were intravenously infused with a dose of 1 μg · kg -1 for 10 min, followed by 0.2-0.7 μg · kg -1 · h -1. Midazolam The rats were given a loading dose of 0.06 mg · kg -1 and then maintained at 0.04-0.20 mg · kg -1 · h -1. Results: Compared with the midazolam group (2.38 ± 0.48) points and (6.07 ± 0.79) points, the visual analogue (VAS) score of dexmedetomidine group was significantly lower than that of midazolam group (P <0.01) (0.17 ± 0.03) h & (1.63 ± 0.56) h, P <0.01]. In the dexmedetomidine group, there were 3 cases of decreased blood pressure, no significant changes in spontaneous breathing frequency; 10 cases of decreased blood pressure in the midazolam group, and 3 cases of spontaneous respiratory rate decline (P <0.05). In dexmedetomidine group, 6 patients had a progressive amnesia, all patients in the midazolam group had a progressive amnesia (P <0.05). Conclusion: Dexmedetomidine is an ideal sedative and analgesic for surgical intensive care unit.