摘要
目的观察右美托咪定联合布托啡诺对ICU多发伤患者镇静镇痛的效果。方法选取2018年6月至2019年6月郑州大学第二附属医院ICU收治的多发伤患者56例,采用数表法随机分为观察组(P组)和对照组(C组),各28例。P组给予右美托咪定联合布托啡诺持续微量泵输注24 h;C组给予咪达唑仑联合瑞芬太尼持续微量泵输注24 h。调整微量泵的输注速度维持镇静Ramsay评分2~4分、重症监护疼痛观察工具(CPOT)评分≤3分。观察两组用药后生命体征及动脉血气分析变化;用药后2、8、16、24 h患者镇静强度(Ramsay)评分及重症监护疼痛观察工具法(CPOT)评分;比较两组镇静镇痛达标时间及谵妄的发生率。结果用药后两组心率(HR)、呼吸频率(RR)、平均动脉压(MAP)均较前降低,差异有统计学意义(P<0.05);与C组相比,P组动脉血氧饱和度(SPO2)、动脉血氧分压(PaO2)明显升高,镇静镇痛达标时间缩短,谵妄的发生率降低,差异有统计学意义(P<0.05)。结论右美托咪定联合布托啡诺对ICU多发伤患者有良好的的镇痛镇静效果。
Objective To investigate the effect of dexmedetomidine combined with butorphanol on sedation and analgesia in patients with multiple ICU injuries.Methods A total of 56 patients with multiple injuries admitted to the ICU of the second affiliated hospital of zhengzhou university from June 2018 to June 2019 were selected and randomly divided into observation group(group P)and control group(group C),with 28 cases each,by numerical table method.In group P,dexmedetomidine combined with butorphanol was continuously injected with micro pump for 24 h.Group C was given midazolam combined with remifentanil for continuous micro pump infusion for 24 h.The infusion speed of the micro pump was adjusted to maintain sedation.The Ramsay score was 2~4 points,and the intensive care pain observation tool(CPOT)score was≤3 points.The changes of vital signs and arterial blood gas analysis were observed.Ramsay scores and CPOT scores of patients at 2,8,16 and 24 h after treatment;The duration of sedation and analgesia and the incidence of delirium were compared between the two groups.Results After treatment,the HR,RR and MAP of the two groups were lower than the previous ones,and the difference was statistically significant(P<0.05).Compared with the C group,the SPO2 and PaO2 in the P group were significantly increased,and the sedation and analgesia time was shortened.The incidence was reduced and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with butorphanol has a good analgesic effect on patients with multiple ICU injuries.
作者
王萌萌
刘小军
李方方
马月影
WANG Mengmeng;LIU Xiaojun;LI Fangfang;MA Yueying(The Second Affiliated Hospital of Zhengzhou University critical care unit,Zhengzhou,Henan 450014,China;The Second Affiliated Hospital of Zhengzhou University Respiratory department,Zhengzhou,Henan 450014,China;The Second Affiliated Hospital of Zhengzhou University Department of anesthesiology,Zhengzhou,Henan 450014,China)
出处
《大医生》
2019年第16期140-141,174,共3页
Doctor
关键词
右美托咪定
布托啡诺
多发伤
镇静镇痛
dexmedetomidine
butorphanol
multiple trauma
sedation
analgesia
