丙泊酚与咪唑安定在机械通气患者镇静的应用  

Application of propofol and midazolam for sedation in patients undergoing mechanical ventilation

作　　者：李卿[1] 黄英姿[1] 刘松桥[1] 刘玲[1] 徐晓婷[1] 杨毅[1] 邱海波[1] 

机构地区：[1]东南大学附属中大医院重症医学科,江苏省210009

出　　处：《江苏医药》2012年第1期79-81,共3页Jiangsu Medical Journal

摘　　要：目的评价丙泊酚与咪唑安定对ICU机械通气患者镇静治疗的疗效及安全性。方法机械通气患者28例随机均分为两组:A组镇静用丙泊酚;B组用咪唑安定;治疗期间,调整药物剂量维持Ramsay评分3-4分。停药清醒后进行自主呼吸测试(SBT),记录并比较评估指标。结果 A组达镇静目标时间[(55.4±52.6)s vs.(156.1±86.5)s]、停药至苏醒时间[(8.4±13.6)min vs.(40.5±24.0)min]、停药至脱机时间[(29.1±19.9)min vs.(66.9±47.9)min]和停药至拔管时间[(66.5±22.7)min vs.(108.9±52.4)min]均明显短于B组(P<0.05或P<0.01)。两组ICU停留时间相仿。A组有2例患者出现血压下降,加快补液速度后血压恢复正常。结论与咪唑安定相比,异丙酚起效快,能缩短机械通气患者脱机时间及拔管时间,但对ICU住院时间无影响。Objective To compare the outcomes of sedation with propofol and midazolam in patients undergoing mechanical ventilation. Methods Twenty-eight patients undergoing mechanical ventilation in ICU were equally randomized into two groups of A（sedation with propofol） and B（sedation with midazolam）. Ramsay sedation score was kept at 4-5 points by adjusting dose. The trial of spontaneous breathing（SBT） was performed after awakened and the criteria were recorded. ResultsThe time to reach goal Ramsay sedation score was significantly shorter in group A than that in group B [（55.4±52.6）s vs.（156.1±86.5）s]（P0.05）. So did the time of awakening [（8.4±13.6）min vs.（40.5±24.0）min],the time of weaning [（29.1±19.9）min vs.（66.9±47.9）min],and the time of extubationtime [（66.5±22.7）min vs.（108.9±52.4）min]（P0.05 or P0.01）.There was no significant difference in ICU stay between two groups.Hypotension was seen in 2 cases of group A during sedation,which was corrected by fluid infusion. Conclusion Compared to midazolam,sedation with propofol in the patients undergoing mechanical ventilation has the advantages of quicker onset and earlier times of awakening,weaning and extubation without affecting ICU stay.

关 键 词：丙泊酚 咪唑安定 机械通气 镇静 

分 类 号：R459[医药卫生—治疗学]