右美托咪啶联合用药新方案用于重症医学科长时间镇静的研究  

A combined protocol for dexmedetomidine used in prolonged sedation in intensive care unit

作　　者：徐进步[1] 汪允珍[1] 施青山[1] 

机构地区：[1]江苏省连云港市第二人民医院重症医学科,222000

出　　处：《中国现代医药杂志》2012年第12期20-22,共3页Modern Medicine Journal of China

摘　　要：目的比较在重症医学科内长时间镇静状态下不同镇静方案的差别,找出较适合长时间镇静的方案。方法选取在我院重症医学科住院的患者80例,随机分为4组,即右美托咪啶持续泵注联合咪达唑仑间断应用组(A组,n=20),右美托咪啶与咪达唑仑联合持续泵注组(B组,n=20),咪达唑仑单独持续泵入组(C组,n=20),右美托咪啶单独持续泵入组(D组,n=20)。镇静目标为肌肉活动评分法(monitor activity assessments cale,MAAS)3分,镇静过程中持续心电监护,监测镇静满意程度,记录4组患者3日用药量变化,并监测患者不良反应发生率。比较4组患者后3种指标的差别。结果 A、B两组较C、D两组镇静满意程度显著增高,用药量变化幅度较小,不良反应较少,其中又以A组不良反应为最少,且与B组相比咪达唑仑用药量显著减少。结论右美托咪啶持续泵注联合咪达唑仑间断应用可显著减少长时间镇静所需药物用量,且减少不良反应。Objective To compare the difference between different sedation method, and to find the most suitable one for prolonged sedation. Methods 80 patients from our intensive care unit were chosen and randomized into 4 groups. They were： group A（n=20）, in which dexmedetomidine was infused continuously, combined with midazolem intermittently;group B（n=20）, in which both dexmedetomidine and midazolem were infused continuously; group C（n=20）, in which midazolem was infused con- tinuously; group D（n=20）, in which dexmedetomidine was given through persistent infusion. The goal of sedation was 3 in mon- itor activity assessment scale （MAAS）. The patients＂ oxygenative and hemodynamic indice were monitored, so did the adverse reactions, the satisfactory degree of sedation, and the three days dosage of sedatives. The latter three indice were compared a- mong the 4 groups. Results The group A and B showed higher satisfactory degree of sedation,more stable dosages, and less adverse reactions than the group C and D. Furthermore, the group A showed even less adverse reactions and midazolem dosages than the group B. Conclusion Continuous dexmedetomidine infusion plus intermittent midazolem application can reduce the dosage of sedatives, and reduce adverse reaction in prolonged sedation.

关 键 词：右美托咪啶 咪达唑仑 长时间镇静 镇静满意程度 药物耐受性 

分 类 号：R614[医药卫生—麻醉学]