右美托咪定联合瑞芬太尼镇静镇痛对ICU机械通气患者疼痛及谵妄发生率的影响

Effects of sedation and analgesia with dexmedetomidine combined with remifentanil on the incidence of pain and delirium in mechanically ventilated patients in ICU

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2021, 48(6)
作者
作者单位

开封市人民医院重症医学科 ;

摘要
【摘要】 分析重症医学科(ICU)机械通气患者应用右美托咪定联合瑞芬太尼镇静镇痛后的效果及谵妄发生率。方法 依据掷币法将本院81例ICU机械通气患者分为右美托咪定组41例及咪达唑仑组40例,咪达唑仑组患者应用芬太尼联合咪达唑仑镇静镇痛,右美托咪定组患者采用瑞芬太尼联合右美托咪定镇静镇痛,对比两组患者疼痛及镇静效果、应激反应变化、呼吸力学指标水平及谵妄、躁动、人机对抗发生率。结果 两组患者镇静后RASS评分无统计学意义(P>0.05),右美托咪定组镇静后24h、48h、72h、96h NRS评分低于咪达唑仑组(P<0.05);镇静后,右美托咪定组NE、Cor、Ptp-ei、△Ptp水平及躁动、谵妄、人机对抗发生率低于咪达唑仑组,Ptp-ee水平高于咪达唑仑组(P<0.05)。结论 右美托咪定联合瑞芬太尼应用于ICU机械通气患者具有较佳的镇痛镇静功用,能够显著抑制机体应激反应,减少对呼吸功能的影响,降低躁动、人机对抗及谵妄发生率。
Abstract
[Abstract] Objective To analyze the effect of dexmedetomidine combined with remifentanil for sedation and analgesia and the incidence of delirium in mechanically ventilated patients in the intensive care unit (ICU). Methods According to the coin toss method, 81 mechanically ventilated ICU patients in our hospital were divided into 41 cases in the dexmedetomidine group and 40 cases in the midazolam group. Patients in the midazolam group were treated with fentanyl and midazolam for sedation Patients in the dexmedetomidine group were treated with remifentanil combined with dexmedetomidine for sedation and analgesia. The pain and sedative effects, changes in stress response, respiratory mechanics index levels, delirium, restlessness, and human-machine confrontation were compared between the two groups Incidence rate. Results The RASS scores of the two groups of patients after sedation were not statistically significant (P>0.05). The NRS scores of the dexmedetomidine group were lower than those of the midazolam group at 24h, 48h, 72h, and 96h after sedation (P<0.05); The levels of NE, Cor, Ptp-ei, △Ptp and the incidence of restlessness, delirium, and human-machine confrontation in the dexmedetomidine group were lower than those in the midazolam group, and the Ptp-ee level was higher than that in the midazolam group (P< 0.05). Conclusion Dexmedetomidine combined with remifentanil has better analgesia and sedation in ICU mechanically ventilated patients, which can significantly inhibit the bodys stress response, reduce the impact on respiratory function, and reduce restlessness, human-machine confrontation and delirium rate.
关键词
【关键词】右美托咪定;瑞芬太尼;镇静镇痛;ICU;机械通气;疼痛;谵妄
KeyWord
[Keywords] dexmedetomidine; remifentanil; sedation and analgesia; ICU; mechanical ventilation; pain; delirium
基金项目
页码 1087-1090
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曹书奎*. 右美托咪定联合瑞芬太尼镇静镇痛对ICU机械通气患者疼痛及谵妄发生率的影响 [J]. 国际精神病学杂志. 2021; 48; (6). 1087 - 1090.

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