摘要
目的观察布托啡诺对ICU心脏术后机械通气患者的镇痛/镇静效果和安全性。方法本院ICU收治的249例心脏术后机械通气患者,按随机数字表法分为布托啡诺+右美托咪定组(n=125例)和芬太尼+右美托咪定组(n=124例),分别记录两组患者用药前后不同时点的CPOT评分、RASS评分、MAP、HR、右美托咪定总用量、机械通气时间、拔管时间、ICU住院时间及不良反应的发生情况。结果布托啡诺组T0时点的CPOT评分较芬太尼组更低(P <0.05)。布托啡诺组使用右美托咪定的剂量小于芬太尼组(P <0.05),机械通气时间、拔管时间、ICU住院时间及不良反应发生率均较芬太尼组明显减少(P <0.05)。结论布托啡诺用于心脏术后机械通气患者与芬太尼镇痛效果相当,与芬太尼相比,起效更快,可减少镇静药物的用量,减少机械通气时间,尽早拔管,且不良反应发生率低,值得临床推广。
Objective To investigate the effect of butorphanol on analgesia and sedation and its safety in patients received mechanical ventilation after cardiac surgery.Methods Two hundred and forty-nine patients with invasive mechanical ventilation after cardiac surgery were randomly divided into butorphanol group(n=125)and fentanyl group(n=124).The dexmedetomidine infusion was started if the additional sedation was necessary.Dur-ing the therapy,the scores of Critical-Care Pain Observation Tool(CPOT)and Richmond Agitation-Sedation scale(RASS)and the vital signs were recorded before and after medication,respectively.The duration of mechanical ventilation,the time of extubation,ICU length of stay and the dosage of dexmedetomidine were recorded.Further-more,the incidence of adverse reactions was documented.Results At T0 time point,CPOT score in butorphanol group was lower than that in fentanyl group(P<0.05).The dosage of dexmedetomidine in butorphanol group was obviously lower than that in fentanyl group(P<0.05).The duration of mechanieal ventilation,the time of extuba-tion and ICU length of stay were shortened in butorphanol group compared with fentanyl group(P<0.05,respec-tively).The adverse reaction rate in butorphanol group was significant lower than that in fentanyl group(P<0.05).Conclusions The effect of butorphanol was similar to that of the traditional opioid analgesics.Butorphanol gives rapid effect,shortens the duration of mechanical ventilation,as well as the time of extubation and ICU length of stay,with no severe adverse effect.
作者
胡苏
武晓灵
HU Su;WU Xiaoling(Intensive Care Unit,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第20期3458-3461,共4页
The Journal of Practical Medicine
基金
湖北省科技计划项目(编号:2017CFC851)
湖北省武汉市卫生计生委科研项目(编号:WX16D34)
关键词
布托啡诺
镇痛/镇静
心脏术后
机械通气
butorphanol
sedation/analgesia
after cardiac surgery
mechanical ventilation
