右美托咪定联合地佐辛对多发伤患者镇静镇痛效果的分析

摘要

Objective To evaluate the efficacy and safety of dexmedetomidine combined with dezocine in sedation and analgesia in the patients with multiple traumas .Methods Sixty patients with multiple traumas were enrolled and randomly divided into dexmedetomidine combined with dezocine group (A group and midazolam combined with fentanyl group (B group) with thirty cases in each group. These indicators as the incidence rate of severe agitation and delirium , the cost of sedation and analgesia drug, the total cost in ICU (except for operation expenses ), the duration of mechanical ventilation , the ICU stay, the incidence rates of cardiovascular adverse events and respiratory depression events were compared between two groups .Results The incidence rates of severe agitation and delirium in group A were significantly less than group B .The incidence rates of cardiovascular adverse events and respiratory depression events in group A were significantly less than group B .The duration of mechanical ventilation and the ICU stay in Group A were shorter than group B (P<0.05).Although the cost of sedation and analgesia drug in group A was higher than that in group B (P<0.05), the total cost in ICU (except for operation expenses ) showed no significant difference ( P >0.05 ).Conclusion Dexmedetomidine combined with dezocine is effective and safe for sedation and analgesia in patients with multiple traumas , which could reduce the occurrence of severe agitation and delirium , shorten the duration of mechanical ventilation and the ICU stay , and decrease the incidence rates of cardiovascular adverse events and respiratory depression events .%目的：评估右美托咪定联合地佐辛对多发伤患者镇静镇痛的有效性及安全性。方法符合入选标准的多发伤患者60例随机分为右美托咪定联合地佐辛组（ A组）30例和咪达唑仑联合芬太尼组（ B组）30例。比较两组患者在ICU住院期间重度躁动和谵妄发生率、镇静镇痛药物费用、ICU总费用（除外手术费用）、机械通气时间和ICU 留住时间、心血管不良反应事件及呼吸抑制事件发生率等指标。结果 A组患者重度躁动和谵妄发生率明显少于B组（P＜0．05）；A组患者心血管不良反应事件和呼吸抑制事件发生率均明显少于B组（P＜0．05）；A组患者机械通气时间和ICU留住时间均比B组更少（P＜0．05）；虽然A组患者镇静镇痛药物费用明显高于B组（P＜0．05），但两组患者ICU总费用（除外手术费用）比较差异无统计学意义（P＞0．05）。结论右美托咪定联合地佐辛用于多发伤患者能获得良好的镇静镇痛效果，降低重度躁动和谵妄的发生，缩短呼吸机使用时间和ICU住院时间，且心血管不良事件和呼吸抑制事件发生率减低。