芬太尼或瑞芬太尼与咪达唑仑复合镇静在ICU机械通气患者中的镇静效果观察  

Sedative effect of fentanyl or remifentanil and midazolam in patients undergoing mechanical ventilation in ICU.

作　　者：秦明钦[1] 陈蒙华[1] 何亚军[2] 

机构地区：[1]广西医科大学第一附属医院西院ICU科,广西南宁530021 [2]广西医科大学第一附属医院西院麻醉科,广西南宁530021

出　　处：《海南医学》2013年第3期363-365,共3页Hainan Medical Journal

摘　　要：目的探讨芬太尼或瑞芬太尼与咪达唑仑复合镇静在ICU机械通气治疗中的镇静效果。方法 30例ICU机械通气的危重患者随机分为两组,瑞芬太尼组(R组)和芬太尼组(F组),采用经中心静脉通路持续微量泵入芬太尼或瑞芬太尼与咪达唑仑复合镇静治疗,记录患者镇静前、镇静后6h、12h、24h和48h的HR、MAP、SpO2、PaCO2、PaO2、pH和CVP;记录镇静后1d、2d、3dSAS评分、用药量。结果两组患者镇静效果均满意,SAS的均值为2～3分。两组患者各时点血流动力学、血气值的变化、镇静镇痛药物的需求量、镇静时间、机械通气时间、ICU停留时间、副作用等方面差异无统计学意义。结论芬太尼或瑞芬太尼与咪达唑仑合用在ICU危重患者机械通气治疗时都能达到理想镇静效果,瑞芬太尼在机械通气时间及ICU停留时间相对短些。Objective To evaluate the sedative effect of fentanyl or remifentanil and midazolam in patients undergoing mechanical ventilation in ICU. Methods Thirty patients were randomly assigned into two groups： remi- fentanil group （group R） and fentanyl group （group F）. The fentanyl or remifentanil and midazolam were pumped via central venous access continuously. The HR, MAP, SpO2, PaCO2, PaO2, PH and CVP before sedation and 6 h, 12 h, 24 h, 48 h after sedation were recorded. The total dosage and SAS values 1, 2, 3 days after sedation were re- corded. Results The sedative effect of the two groups were both satisfactory, with the mean SAS of 2-3. There was no statistically significant difference between the two groups of each time point in hemodynamics, blood gas values, the dosage of the sedative analgesic drugs, sedation time, side effects, duration of mechanical ventilation and ICU de-tention time. Conclusion Fentanyl or remifentanil and midazolam can achieve ideal sedative effect in patients under-going mechanical ventilation. Remifentanil combined with midazolam results in relatively shorter duration of mechani-cal ventilation and ICU detention time.

关 键 词：芬太尼 瑞芬太尼 咪达唑仑 ICU 机械通气 

分 类 号：R971.3[医药卫生—药品]