瑞马唑仑用于VA-ECMO支持患者的镇静效果  

Sedation efficacy of remimazolam in patients undergoing VA-ECMO support

作　　者：张晓玲[1] 潘飞艳 陈琨[1] 徐晓[1] 朱良梅 ZHANG Xiaoling;PAN Feiyan;CHEN Kun;XU Xiao;ZHU Liangmei(Department of Intensive Care Medicine,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,CHINA)

机构地区：[1]浙江大学附属金华医院重症医学科,浙江金华321000

出　　处：《江苏医药》2024年第7期675-678,共4页Jiangsu Medical Journal

基　　金：浙江省科技计划项目(2020C03019);浙江省中医药科技计划项目(2023ZL188);金华市中医药科学技术研究计划项目(2023KY04)。

摘　　要：目的观察瑞马唑仑对静脉-动脉体外膜肺氧合(VA-ECMO)支持患者的镇静效果。方法100例接受VA-ECMO支持患者随机分为试验组(采用瑞马唑仑镇静,50例)和对照组(采用丙泊酚镇静,50例)。镇静目标为维持Richmond躁动-镇静量表(RASS)评分-4~-3分。比较两组患者达到镇静目标所需的时间、苏醒时间和镇静期间药物的不良反应发生情况。结果两组患者镇静达标比例、达到镇静目标时间、机械通气时间和住重症监护室时间差异均无统计学意义(P>0.05)。试验组苏醒时间早于对照组(P<0.05)。试验组血压下降和呼吸抑制发生比例低于对照组(P<0.05),而两组患者心率下降、心力衰竭、呛咳、呢逆发生比例差异无统计学意义(P>0.05)。结论与丙泊酚比较,瑞马唑仑用于VA-ECMO支持患者的镇静时苏醒较快,血压下降和呼吸抑制等不良反应较少。Objective To observe the sedation efficacy of remimazolam in the patients undergoing the support of veno-arterial extracorporeal membrane oxygenation(VA-ECMO).Methods A total of 100 patients undergoing VA-ECMO support were randomly divided into two groups of A(sedated by remimazolam,50 cases)and B(sedated by propofol,50 cases).The sedation goal was to maintain the Richmond agitation sedation scale(RASS)score of-4 to-3 points.The time required to achieve sedation goal,recovery time and the occurrence of adverse drug reactions during sedation were compared between the two groups.Results sThere were no significant differences in the proportion of the patients reaching sedation goal,the time required to achieve sedation goal,the time of mechanical ventilation and the intensive care unit stay between the two groups(P>0.05).The recovery time in group A was shorter than that in group B(P<0.05).The proportion of the patients with a decrease of blood pressure and respiratory depression in group A was lower than that in group B(P<0.05),but there was no statistical significance in the proportion of the patients with decreased heart rate,heart failure,cough and hiccup between the two groups(P>0.05).Conclusion Compared with propofol,the patients undergoing VA-ECMO support and sedated with remimazolam awaken more quickly and have less adverse effects such as decreased blood pressure and respiratory depression,

关 键 词：瑞马唑仑 丙泊酚 静脉-动脉体外膜肺氧合 镇静 

分 类 号：R614[医药卫生—麻醉学]