摘要
目的应用脑电双频谱指数(BIS值)监测镇静水平,观察异丙酚和咪唑安定对重症监护病房(ICU)患者机械通气治疗时镇静效果。方法选取2005年9月～2006年1月ICU病房患者40例,随机分为2组,每组20例。每组患者持续微量泵泵入异丙酚和咪唑安定。Ⅰ组患者使Ramsay评分在2～3级,Ⅱ组患者使Ramsay评分在3～4级,分别记录BIS值,并注意维持患者血流动力学稳定。结果Ⅰ组、Ⅱ组BIS值分别维持在70～80、60～70,此时异丙酚用量分别为(8.91±2.52)、(11.72±3.43)μg/(kg·min),咪唑安定用量(0.31±0.10)、(0.35±0.09)μg/(kg·min);与镇静前相比,Ⅰ组患者镇静后平均动脉压(MAP)由(9.37±1.28)kPa[(70.28±9.61)mmHg]降至(9.25±1.50)kPa[(69.41±11.25)mmHg],心率(HR)由(95.2±12.8)次/分增至(97.4±11.9)次/分,差异无统计学意义(P>0.05);而Ⅱ组患者镇静后MAP由(9.67±1.20)kPa[(72.52±8.96)mmHg]降至(8.50±1.14)kPa[(63.77±8.53)mmHg],HR由(91.7±8.9)次/分增至(99.2±9.3)次/分,差异有统计学意义(P<0.05)。结论在ICU对机械通气患者采用BIS值监测,能客观反映患者的镇静深度,根据机械通气治疗时不同患者病情要求,做到适量应用镇静剂,减少由于镇静不当引起的并发症。
Objective To study the therapeutic effect of propofol and midazolam on patients during mechanical ventilations in ICU by using bispectral index （BIS）. Methods During September 2005 to January 2006,40 patients in ICU were randomly divided into two groups（n = 20 each）. By transfusing propofol and midazolam with injecting pump,the score of Ramsay of group Ⅰ and Ⅱ were controlled within 2 ～ 3 and 3 ～ 4, respectively. Results The BIS of group Ⅰ and Ⅱ were controlled within 70 ～ 80 and 60 ～ 70. At the same time,the dose of propofol were （8.91 ± 2.52） μg/（kg·min）, （11.72 ± 3.43） μg/（kg·min） and the dose of midazolam were （0.31 ± 0.10） μg/（kg·min）, （0.35 ± 0.09） μg/（kg·min） ,respectively.Compared with the presedation ,the mean blood pressure of the patients in group Ⅰ declined from （9.37 ± 1.28） kPa[（70.28 ± 9.61 ） mmHg] to （9.25 =1= 1.50） kPa[（69.41±11.25） mmHg] while heart rate improved from （95.2 ± 12.8）/min to （97.4 ± 11.9）/min,was not significant difference （P 〉 0.05）. But it was significant difference in group Ⅱ （P 〈 0.05 ）. Conclusion The application of BIS can make good judgement objectively in sedation of patients during mechanical ventilations in ICU. By using BIS different choices for various needs can be selected to obtain ideal sedation effect and avoid from the complication of sedation.
出处
《生物医学工程与临床》
CAS
2007年第1期20-22,共3页
Biomedical Engineering and Clinical Medicine
关键词
脑电双频谱指数
机械通气
镇静
重症监护
bispectral index
mechanical ventilation
sedation
intensive care unit
