摘要
目的 观察咪达唑仑在机械通气患者中的应用 ,评价其镇静效果及可能的不良反应。方法 3 0例符合观察要求的机械通气患者 ,以微量泵持续静脉注入咪达唑仑。负荷剂量 8～ 12 μg kg ,维持量 5～ 12 μg·kg- 1 ·h- 1 ,用药时间不超过 72h。观察镇静情况 (Ramsayscore ,RS评分 )、血压、脉搏、血氧饱和度、呼吸频率的变化及停药后的拔管情况。结果 所有患者在给咪达唑仑负荷剂量后 ,RS从 1级下降至 3～ 5级 ,达到很好的镇静要求 ,且在维持量下能保持良好的镇静水平 ,有效率 10 0 % ;患者的血压在用药前后和维持过程中均无明显差异 ;心率与血氧饱和度在给负荷剂量后 5min与治疗前有显著差异 (P <0 .0 5 ) ;自主呼吸频率用药后与用药前对比有非常明显的改善 (P <0 0 1) ;符合拔管条件的患者停药后都能很快拔除气管导管。结论 咪达唑仑静脉微量泵推注能很好地应用于ICU中机械通气的患者 ,镇静效果好、循环影响小、能保持患者的自主呼吸与机械通气协调 ,减少人机对抗 ,用药
Objective To evaluate the sedative effect and the possible side effects of midazolam in patients undergoing mechanical ventilation in ICU. Methods A total of 30 patients undergoing mechanical ventilation in ICU accordant with the demands were intravenously injected with midazolam at the dose of 8-12 μg/kg and the maintenance dose of 5-12 μg·kg -1 ·h -1 . The total administration time was not more than 72 h. ECG, BP, SpO 2, and RR were routinely observed, and the level of sedation was assessed using Ramsay score (RS). Results RS of all patients decreased from grade 1 to grades 3 - 5 after administration of the loading dose. All patients got a calm state and kept it under the maintenance dose. No significant difference in BP was found in all patients during the course. HR and SpO 2 changed at 5 min after administration of the loading dose. Significant improvement of autonomous breathing was found after administration of midazolam (P<0.05). All patients accorded with the demands were weaned from respiratory support soon after midazolam was stopped. Conclusion Intravenous administration of midazolam can be used in patients undergoing mechanical ventilation in ICU accordant with the demands, resulting in a good calm state, less effects on the hemodynamics, and good coordination of autonomous breathing of patients with the mechanical ventilation.
出处
《局解手术学杂志》
2004年第6期370-372,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
咪达唑仑
呼吸功能不全
机械通气
midazolam
respiratory disfunction
mechanical ventilation
