【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。更多还原

【Abstract】 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: remifentanil 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 recorded. 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 detention time. Conclusion Fentanyl or remifentanil and midazolam can achieve ideal sedative effect in patients undergoing mechanical ventilation. Remifentanil combined with midazolam results in relatively shorter duration of mechanical ventilation and ICU detention time.更多还原