摘要
目的:探讨咪达唑仑-舒芬太尼在机械通气治疗多发肋骨骨折患者的中镇痛镇静效果。方法:18例接受机械通气患者均予首剂静脉注射咪达唑仑0.15～0.3mg/kg、舒芬太尼1～2μg/kg镇痛镇静负荷量,后予咪达唑仑0.05～0.1mg/kg/h、舒芬太尼0.3～1.5μg/kg/h微泵注射维持,根据患者情况个体化调整入量,维持镇静Ramsay评分在3～4分水平,通过监测患者心率、呼吸、平均动脉压及动脉血气分析进行治疗前后对比评估。结果:在负荷剂量及维持量下所有患者均能够达到目标镇痛镇静效果,Ramsay评分均在3～4分。患者用药1h后HR、RR、SaO2,平均动脉压及动脉血气pH值、PaO2、PaCO2均较用药前明显改善(P<0.01)。结论:对ICU机械通气治疗多发性肋骨骨折的患者,咪达唑仑-舒芬太尼能显著提高患者的镇痛镇静效果,避免"人-机对抗",改善氧合,降低耗氧,效果确切。
Objective：To investigate the effects of midazolam-sufentanil during mechanical ventilation in the treatment of multiple ribs fracture patients in sedation and analgesia effect.Methods： 18 cases of patients receiving mechanical ventilation to the first dose of intravenous midazolam 0.15 ～ 0.3mg / kg,with 1 to 2 μ g / kg of analgesic and sedation of load,then with midazolam 0.05 ～ 0.1mg / kg/h,with 0.3 to 1.5 μ g/kg/h micropump injection maintenance,according to patients condition a the amount of adjustment,maintain calm Ramsay score in the 3 to 4 level,heart rate,breathing through the monitoring of patients,mean arterial pressure and arterial blood gas analysis were compared before and after treatment to evaluate.Results： In the loading dose and maintenance dose of all patients were able to reach the goals of sedation and analgesia effect,Ramsay score was 3 ～ 4.Drug use in patients after 1h HR,RR,SaO2,mean arterial pressure and arterial blood gas pH,PaO2,PaCO2 were obviously improved than before treatment（P0.01）.Conclusion： ICU of mechanical ventilation in the treatment of multiple ribs fracture patients,midazolam-sufentanil can significantly improve patient sedation and analgesia effect,avoid ＂man machine confrontation＂,improve oxygenation,reduce oxygen consumption,the exact effect.
出处
《中国医药导刊》
2013年第3期485-486,共2页
Chinese Journal of Medicinal Guide
关键词
咪达唑仑
舒芬太尼
多发肋骨骨折
机械通气
镇痛镇静
Midazolam
Sufentanil
Multiple Rib Fracture
Mechanical Ventilation
SedationAnalgesia
