右美托咪定在重症监护病房镇静中的临床应用  

Clinical application of dexmedetomidine in Intensive Care Unit

作　　者：彭绵[1] 方伟强[1] 余雪涛[1] 蔡举瑜[1] 

机构地区：[1]汕头大学医学院第一附属医院ICU,广东515041

出　　处：《中国急救医学》2011年第3期197-199,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 评估右美托咪定在重症监护病房镇静治疗中的效果及安全性.方法 70例有创机械通气的ICU患者应用右美托咪定镇静,控制镇静水平RamsayⅢ～Ⅳ级,以咪达唑仑作为对照,分别记录镇静起效时间、平均负荷剂量、维持剂量、停用镇静剂后苏醒时间及不良反应的发生率.结果 与咪达唑仑比较,右美托咪定起效迅速[（57.7±6.2）s vs （117.5±13.1）s,P〈0.05],镇静的同时保持可唤醒能力[苏醒时间（0.20±0.03）min vs（11.30±2.10）min,P〈0.05],治疗剂量内不诱发临床意义的呼吸抑制（发生率0.2%,P〈0.05）,血流动力学影响小（平均动脉压降低3.3%,心率减慢3.9%）.结论 右美托咪定是重症患者镇静的良好选择.Objective To evaluate the efficacy and safety of dexmedetomidine in the sedation of ICU patients. Methods Dexmedetomidine was given to 70 ICU patients with mechanical ventilation. Sedation level was maintained Ramsay score Ⅲ - Ⅳ with midazolam as control. The onset time, mean loading doses, maintaining doses, recovery time and incidence of adverse reactions were monitored. Results Dexmedetomidine had rapid sedation in mechanically ventilated patients [ onset time （57.7 ± 6.2） s vs midazolam （ 117.5 ± 13. 1 ） s, P 〈 0. 05 ], while maintained a high degree of reusability [ recovery time （0.20 ± 0.03 ） min vs midazolam （ 11.30 ± 2. 10） rain, P 〈 0. 05 ]. There was rare clinical important respirator）, depression （0. 2% ） and little effects on hemodynamic （incidence of decreased MAP 3.3% and dropped HR 3.9% ）. Conclusion Dexmedetomidine can serve as an ideal agent of sedation for the patients in critical care settings.

关 键 词：右美托咪定 重症监护病房 镇静 

分 类 号：R181.34[医药卫生—流行病学]