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目的:比较右美托咪定与咪达唑仑在体外循环(CPB)心脏术后机械通气患者撤机过程中的应用安全性。方法:选择金华市人民医院2016年8月至2018年12月收治的CPB心脏术后机械通气患者51例为研究对象，按照随机数字表法分为右美托咪定组(26例)及咪达唑仑组(25例)，分别给予右美托咪定和咪达唑仑镇静治疗，分别统计两组患者机械通气时间、重症疼痛观察工具(CPOT)评分、重症监护谵妄筛查量表(ICDSC)评分、机械通气期间窦性心动过缓发生率以及撤机拔管后患者回访有无顺行性遗忘情况，比较并评价不同镇静药物在CPB心脏术后机械通气患者中的撤机安全性及相关因素影响。结果:右美托咪定组CPOT评分[(1.04±0.45)分]显著低于咪达唑仑组[(2.24±0.83)分]，差异有统计学意义(n t＝－6.40，n P0.05)；右美托咪定组机械通气时间为(29.71±17.96)h，咪达唑仑组为(26.13±20.02)h，差异无统计学意义(n t＝0.67，n P>0.05)；机械通气镇静期间右美托咪定组发生心动过缓情况更多，差异有统计学意义(χn 2＝11.96，n P0.05). During mechanical ventilation sedation, the dexmedetomidine group had more bradycardia, the difference was statistically significant(χn 2=11.96, n P<0.01). There was no anterograde amnesia in the dexmedetomidine group, but all of the patients in the midazolam group had anterograde amnesia.n Conclusion:Compared with the midazolam group, the CPOT score was lower in the dexmedetomidine sedation group with the same SAS score of 4(superficial sedation), which in line with the principles of “ deep analgesia, shallow sedation”. Although bradycardia occurs during the use of drugs, it can recover spontaneously after withdrawal and is safe to use.