摘要
目的:对比布托啡诺、瑞芬太尼在危重病患者机械通气中的镇静镇痛效果。方法:66例行机械通气的危重病患者,随机分为布托啡诺组和瑞芬太尼组(每组33例),观察并记录镇静镇痛前、镇静镇痛后24hMAP、HR、RR的变化,用药后6h、12h、18h、24h的VAS和Ramsay评分,丙泊酚总用量,药物起效时间,谵妄发生率,低血压发生率,心动过缓发生率。结果:两组患者用药后MAP、HR、RR均较用药前减低(P<0.05),均达到预期的镇静镇痛效果,两组患者各时间观察点VAS和Ramsay评分比较差异无统计学意义(P>0.05)。丙泊酚用量、药物起效时间、谵妄发生率两组无明显差异(P>0.05)。瑞芬太尼组低血压和心动过缓发生率高于布托啡诺组(P<0.05),需要药物干预低血压和心动过缓比例无明显差异(P>0.05)。结论:布托啡诺、瑞芬太尼用于危重病患者机械通气中镇静镇痛均安全有效,但应重视瑞芬太尼对心血管的抑制作用。
Objective： Comparison of sedative and analgesic effects of butorphanol, remifentanil in critically ill patients with mechanical ventilation. Methods： 66 patients who received mechanical ventilation in intensive care unit. Were randomly divided into butorphanol group and remifentanil group （33 cases in each group）, the changes of MAP,RR, HR before sedation and analgesia and after Sedation and analgesia, VAS H and Ramsay score of 6h, 12h, 18h, 24h after medication, the total dosage of propofol, drug onset time, the incidence of delirium, the incidence of hypotension, bradycardia Beckoning incidence were observed and recorded. Results： Compared with before treatment, RR, HR and MAP of two groups were decreased after the treatment （P〈0.05）. The expected sedative and analgesic effects were achieved,VAS and Ramsay scores of two group patients were not statistically significant at each time point（P〉0. 05）. The dosage of propofol, Drug onset time the incidence rate of delirium in two groups had no significant difference （P〉 0. 05）. The incidence rate of hypotension and tachycardia in remifentanil group was high. Remifentanil group compared with butorphanol group, Intervention of hypotension and tachycardia used drug has no significant differences （P〉0. 05）. Conclusion： Sedative and analgesic effects of butorphanol, remifentanil in critically ill patients with mechanical ventilation were safe and effective, However, the inhibition effect of remifentanil on cardiovascular system should be pay attention to.
出处
《医学理论与实践》
2016年第18期3167-3168,3171,共3页
The Journal of Medical Theory and Practice
关键词
布托啡诺
瑞芬太尼
危重病
机械通气
Butorphanol, Remifentanil, Critically ill, Mechanical ventilation
