右美托咪定复合酒石酸布托啡诺用于机械通气患者镇痛效果评价

李小君

【摘要】 目的 探究右美托咪定复合酒石酸布托啡诺对机械通气患者的临床镇痛效果。方法 60例行机械通气的患者随机分为试验A组与试验B组， 各30例。对试验A组患者采用右美托咪定复合酒石酸布托啡诺镇痛治疗方案， 对试验B组采用咪达唑仑复合酒石酸布托啡诺镇痛治疗方案， 对两组患者镇痛时间、用药后唤醒时间及发生谵妄情况进行比较， 同时记录两组患者治疗前及治疗后心率、呼吸及血压水平。结果 试验A组患者镇痛时间、用药后唤醒时间、谵妄情况发生率均低于试验B组， 差异有统计学意义（P<0.05）；试验A组患者治疗后心率及血压降低幅度均高于试验B组， 差异有统计学意义（P<0.05）， 但A组血压仍处于较安全水平；两组患者呼吸频率差异无统计学意义（P>0.05）。结论 对机械通气患者采用右美托咪定复合酒石酸布托啡诺进行镇痛， 具有起效快、患者易唤醒等优点， 且安全性较高。

【关键词】 镇静；机械通气；右美托咪定

DOI：10.14163/j.cnki.11-5547/r.2016.08.005

Evaluation of analgesic effect by dexmedetomidine combined with butorphanol tartrate for mechanical ventilation patients LI Xiao-jun. Dujiangyan City Peoples Hospital， Dujiangyan 611830， China

【Abstract】 Objective To investigate clinical analgesic effect by dexmedetomidine combined with butorphanol tartrate for mechanical ventilation patients. Methods A total of 60 patients receiving mechanical ventilation were randomly divided into experimental group A and experimental group B， with 30 cases in each group. The experimental group A received dexmedetomidine combined with butorphanol tartrate for analgesia， and the experimental group B received midazolam combined with butorphanol tartrate for analgesia. Analgesia time， post-administration wake up time and occurrence of delirium were compared between the two groups. Records were made on heart rate， breath and blood pressure levels before and after treatment in both groups. Results The experimental group A had all lower analgesia time， post-administration wake up time and incidence of delirium than the experimental group B， and the difference had statistical significance （P<0.05）. After treatment， the experimental group A had higher reducing level of heart rate and blood pressure than the experimental group B， and their difference had statistical significance （P<0.05）， while group A had blood pressure at safety level. The difference of respiratory rate had no statistical significance between the two groups （P>0.05）. Conclusion Implement of dexmedetomidine combined with butorphanol tartrate in mechanical ventilation patients for analgesia can show advantages of quick onset and easy wake up， along with high safety.

【Key words】 Sedation； Mechanical ventilation； Dexmedetomidine

ICU患者常因病情较为严重， 需进行机械通气作为辅助治疗手段， 但因此会给患者造成极大痛楚， 故导致部分患者出现焦急、烦躁等不良情绪， 甚至出现拔管等行为， 极大的干扰治疗过程[1， 2]。为此， 探寻有效缓解患者疼痛的治疗方案， 以维持患者身心平稳， 提高治疗效果成为相关医疗人员的工作重点， 本次研究为探寻有效镇痛药物， 选取本院的60例机械通气患者进行对照研究， 现报告如下。

1 资料与方法

1. 1 一般资料 选取2012年9月～2015年4月在本院ICU进行重度创伤治疗的60例患者， 男34例， 女26例， 平均年龄（45.36±6.49）岁， 全部患者均进行机械通气治疗， 并排除以下情况：患者存在心、肺功能障碍；患者伴有肝肾损伤；患者存在意识障碍或不愿配合治疗方案。……