右美托咪啶与咪达唑仑对于酗酒患者全身麻醉术后镇静的比较研究  

A comparative study on sedative effect of dexmedetomidine and midazolam in drunken patients after general anesthesia

作　　者：郑文涛[1] 孙振棣[1] 刘振吉[1] 

机构地区：[1]山东省滨州市人民医院重症医学科,256600

出　　处：《中国医师进修杂志》2015年第12期909-912,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较右美托咪啶与咪达唑仑用于酗酒患者全身麻醉术后镇静的效果及不良反应。方法选择有酗酒史、全身麻醉术后机械通气的患者38例，按随机数字表法分为右美托咪啶组和咪达唑仑组，每组19例。比较两组患者镇静起效时间、躁动、睡眠满意、机械通气时间、ICU住院时间及不良反应情况。结果右美托咪啶组镇静起效时间、机械通气时间明显短于咪达唑仑组[（45．6±8．9）s比（112．5±20-3）s、（9．4±2．1）h比（18．6±5．1）h]，躁动例数明显少于咪达唑仑组（6例比14例），睡眠满意例数明显多于咪达唑仑组（12例比4例），差异有统计学意义（P〈0．05）；两组ICU住院时间比较差异无统计学意义（P〉0．05）。右美托咪啶组心动过缓例数明显多于咪达唑仑组（9例比2例），而呼吸抑制例数明显少于咪达唑仑组（4例比12例），差异有统计学意义（P〈0．05）；两组谵妄、低血压例数比较差异无统计学意义（P〉0．05）。结论与咪达唑仑相比，右美托咪啶可作为酗酒患者全身麻醉术后镇静的优先选择药物，但应注意循环系统的不良反应。Objective To compare the sedative efficacy and untoward effect of dexmedetomidine and midazolam in drunken patients after general anesthesia. Methods Thirty-eight drunken patients having underwent mechanical ventilation after general anesthesia were enrolled. The patients were divided into dexmedetomidine group and midazolam group with 19 cases each according to random digital table method. The sedation onset time, dysphoria, percentage of with good sleep quality, duration of mechanical ventilation, ICU length of staying and untoward effect were compared. Results The sedation onset time and duration of mechanical ventilation in dexmedetomidine group were significantly shorter than those in midazolam group： （45.6 ＋8.9） s vs. （112.5 ＋20.3） s and （9.4 ＋-2.1） h vs. （18.6 ＋5.l） h, the patients of dysphoria in dexmedetomidine group was significantly less than that in midazolam group： 6 cases vs. 14 cases, the patients of good sleep quality in dexmedetomidine group was significantly more than that in midazolam group： 12 cases vs. 4 cases, and there were statistical differences （P 〈 0.05）. There was no statistical difference in ICU length of staying between 2 groups （P 〉 0.05）. The patients of bradyarrhythmia in dexmedetomidine group was significantly more than that in midazolam group： 9 cases vs. 2 cases, but the patients of respiratory depression in dexmedetomidine group was significantly less than that in midazolam group： 4 cases vs. 12 cases, and there were statistical differences （P 〈 0.05）. There were no statistical differences in delirium and hypopiesis between 2 groups （P 〉 0.05）. Conclusion Compared with midazolam, dexmedetomidine is highly recommended to be used for the sedation of drunken patients after general anesthesia, but the incidence of circulatory adverse reactions should be paid attention to.

关 键 词：右美托咪啶 咪达唑仑 全身麻醉 镇静 

分 类 号：R614[医药卫生—麻醉学]