右美托咪定用于体外循环心内直视手术对患者术后镇静的效果  

Postoperative sedation efficacy and safety of dexmedetomidine in cardiac surgery patients

作　　者：柴云飞[1] 雷迁[1] 雷黎明[2] 李鹏[2] CHAI Yunfei;LEI Qian;LEI Liming;LI Peng(Department of Anesthesiology Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of SICU,Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省人民医院(广东省医学科学院),广东省心血管病研究所麻醉科,广州市510080 [2]广东省人民医院(广东省医学科学院),广东省心血管病研究所SICU,广州市510080

出　　处：《实用医学杂志》2017年第12期2022-2024,共3页The Journal of Practical Medicine

基　　金：广东省卫生厅基金资助课题(编号:A2016051)

摘　　要：目的:探讨右美托咪定用于体外循环心内直视手术后患者的ICU镇静效果和安全性。方法:选取体外循环心内直视手术后转入ICU行机械通气的患者90例,将患者随机分为右美托咪定组(D组)45例和丙泊酚组(P组)45例,分别接受右美托咪定和丙泊酚静脉持续镇静。观察并记录两组患者镇静评分、机械通气时间、舒芬太尼24 h用量、ICU住院时间等参数,以及低血压、谵妄、心动过缓等不良反应发生率。结果:两组患者镇静满意度均>80%,差异无统计学意义(P>0.05);D组患者机械通气时间明显短于P组(P>0.05);D组舒芬太尼24 h用量及ICU住院时间均少于P组(P<0.01)。两组在镇静治疗过程中低血压发生率D组低于P组(P<0.05),心动过缓及谵妄发生率差异无统计学意义(P>0.05)。结论:右美托咪定用于体外循环心内直视手术患者术后镇静安全有效,且有助于促进患者术后恢复。Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiacsurgery patients in intensive care unit.Methods A total of90cardiac surgery patients in the intensive care unit(ICU)were randomly assigned into dexmedetomidine group(D group,45cases)and propofol group(P group,45cases)to receive dexmedetomidine or propofol respectively for post?operative sedation.The ratio of sedation satisfac?tion was evaluated and calculated by Riker sedation?agitation scale(SAS),and the duration of mechanical ventila?tion,24?hour consumption of sufentanil,ICU staying time,and the incidences of side?effects(such as hypoten?sion,bradycardia,delirium etc)were recorded during the observation period.Results No significant differenceswere found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the twogroups(P>0.05).The duration of mechanical ventilation and ICU staying time were significantly shorter in Dgroup than that in P group(P<0.01),while the24?hour consumption of sufentanil and the incidences of hypoten?sion and delirium were significantly lower than that in P group(P<0.05).Conclusion Using the dexmedetomi?dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe,andthe postoperative recovery of patients may be enhanced by the drug using.

关 键 词：右美托咪定 体外循环 心脏手术 术后镇静 

分 类 号：R614[医药卫生—麻醉学]