右美托咪啶与咪唑安定对床旁气管切开时重症患者的影响

目的探讨右美托咪啶与咪唑安定对床旁气管切开时重症患者的影响。方法 30例重症患者按随机数字表法分为2组：对照组和观察组,每组15例。对照组术前使用咪唑安定,观察组术前使用右美托咪啶。2组患者均采用利多卡因局部麻醉,均行气管切开术。观察2组患者行气管切开术后总镇静时间、Ramsay评分、镇痛效率及心率（HR）、中心静脉压（CVP）及有无低血压发生等情况。结果与对照组比较,观察组镇静时间短（P〈0.05）,HR下降明显（P〈0.01）。观察组、对照组低血压发生率分别为6.7%、33.3%,2组比较差异有统计学意义（P〈0.01）。观察组Ramsay评分值及CVP值与对照组比较差异均无统计学意义（均P〉0.05）。结论右美托咪啶在镇静、镇痛及减轻应激反应等方面优于咪唑安定,是重症患者有创操作时术前有效的药物。

Effects of Dexmedetomidine and Midazolam in Bed-side Tracheotomy in Critically Ill Patients

Objective To explore the effects of Dexmedetomidine and Midazolam in bed-side tracheotomy in critically ill patients.Methods Thirty critically ill patients were randomly assigned to preoperatively receive either Midazolam（control group,n=15） or Dexmedetomidine（observation group,n=15）.All patients underwent tracheotomy with lidocaine for local anesthesia.The total sedative time,ramsay score,analgesic efficiency,heart rate,central venous pressure and incidence of hypotension were observed postoperatively.Results Compared with control group,the sedative time and heart rate significantly decreased in observation group（P0.05 or P0.01,respectively）.The incidence of hypotension in observation group was obviously lower than that in control group（6.7% vs 33.3%,P0.01）.There were no significant differences in Ramsay score and central venous pressure between the two groups（all P0.05）.Conclusion Dexmedetomidine is more effective for sedation,analgesia and reducing stress response than Midazolam in critically ill patients.