脑电双频指数联合脑电频谱对比右美托咪定和苯磺酸瑞马唑仑的浅镇静效果  

Comparison of the shallow sedative effects of dexmedetomidine and remazolam besylate using bispectral index combined with electroencephalogram spectrum

作　　者：董琦 尚益如 王健楠 郭海涛[4] DONG Qi;SHANG Yiru;WANG Jiannan;GUO Haitao(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471000,China;The First Bethune Hospital of Jilin University,Changchun 130000,China;Jilin Cancer Hospital,Changchun 130000,China)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000 [2]河南科技大学临床医学院,河南洛阳471000 [3]吉林大学白求恩第一医院,长春130000 [4]吉林省肿瘤医院,长春130000

出　　处：《长春中医药大学学报》2024年第12期1368-1371,共4页Journal of Changchun University of Chinese Medicine

基　　金：2021年吉林省卫生科研人才专项项目(SY2021SCZ30);中关村精准医学基金会临床科研专项资助基金项目(2024-03-052)。

摘　　要：目的通过对重症监护室机械通气患者镇痛镇静的主观及客观监测,探讨苯磺酸瑞马唑仑和右美托咪定对患者浅镇静的效果,促进临床实施精准有效的镇痛镇静策略。方法选取2024年1月—2024年5月河南科技大学第一附属医院重症监护室行机械通气治疗超过24 h的患者60例,按随机数表法分为观察组与对照组,各30例。2组均使用瑞芬太尼镇痛。观察组给予苯磺酸瑞马唑仑镇静;对照组予右美托咪定镇静。比较2组一般资料、Richmond镇静-躁动评分(RASS)、相对频带能量(RBP)、95%光谱边缘频率(SEF)、使用补救镇静药物的时间百分比。结果2组RASS评分达浅镇静率均为67.4%;2组左右两侧δ波、θ波、α波、β波均呈依次减少趋势;对照组δ波、θ波RBP高于对照组(P<0.05);对照组α波、δ波RBP高于观察组,且差异有统计学意义(P<0.05);观察组左右两侧95%SEF均高于对照组(P<0.05);对照组使用补救镇静药物的时间百分比(4.91%)高于观察组(2.81%)。结论量化脑电图有助于重症监护人员优化不同药物基因组学个体的镇静药物剂量,可为临床机械通气患者镇静镇痛治疗发展提供理论指导。Objective To explore the effects of remazolam besylate and dexmedetomidine on shallow sedation of patients with mechanical ventilation in intensive care unit through subjective and objective monitoring of analgesia and sedation,in order to promote the implementation of precise and effective analgesic and sedative strategies in clinical practice.Methods 60 patients who were admitted to the intensive care unit of the First Affiliated Hospital of Henan University of Science and Technology for mechanical ventilation treatment for more than 24 hours from January 2024 to May 2024 were selected and divided into the observation group and the control group according to random number table method,with 30 cases in each group.Both groups received remifentanil for analgesia.The observation group received remazolam besylate for sedation,while The control group received dexmedetomidine for sedation.Baseline data,Richmond Agitation and Sedation Scale(RASS)scores,relative band power(RBP),95%spectral edge frequency(SEF),and the percentage of time spent using rescue sedative drugs were compared between two groups.Results The shallow sedation rate achieved by RASS scores in both groups was 67.4%;Theδwave,θwave,αwave,andβwave on both sides of two groups showed a decreasing trend in sequence.The RBP ofδandθwaves in the control group was higher than that in the observation group(P<0.05).The RBP ofαandδwaves in the control group was higher than that in the observation group,and there was statistically significant difference(P<0.05).The 95%SEF on both sides of the observation group was higher than that of the control group(P<0.05).The percentage of time spent using rescue sedative drugs in the control group(4.91%)was higher than that in the observation group(2.81%).Conclusion Quantitative electroencephalogram can help intensive care staffoptimize the dosage of sedative drugs for different pharmacogenomic individuals,providing theoretical guidance for the development of sedative and analgesic therapy for patients with mechanical

关 键 词：脑电双频指数 脑电频谱分析 右美托咪定 苯磺酸瑞马唑仑 浅镇静 

分 类 号：R971.2[医药卫生—药品]