不同剂量右美托咪定对机械通气患者镇静效果和血流动力学的影响被引量：24

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摘要目的:观察不同剂量右美托咪定对机械通气患者镇静效果和血流动力学的影响。方法:入监护室行机械通气的咽成形术后患者45例,随机分为A、B、C组,每组15例,按分组静脉微泵给予右美托咪定。A组:负荷剂量0.5μg/kg,维持剂量0.2μg/(kg·h);B组:负荷剂量0.75μg/kg,维持剂量0.3μg/(kg·h);C组:负荷剂量1.0μg/kg,维持剂量0.4μg/(kg·h)。如患者躁动,静脉单次给予吗啡5mg。机械通气24h后,停止右美托咪定输注,待患者完全清醒,肌力恢复,满足拔管条件后拔除气管导管。观察并记录给药前即刻(T0)、给药结束后即刻(T1)、给药后30min(T2)、给药后1h(T3)、给药后6h(T4)、给药后12h(T5)、给药后24h(T6)的无创动脉血压和心率,观察并记录上述各时点的镇静评分(Ramsay分级法),记录各组吗啡的总用量,观察并记录各组停止右美托咪定输注后至拔管所需时间。结果:血流动力学:A、B、C组部分时点动脉血压、心率较T0有所改变,差异有统计学意义;C组与A、B组间部分时点动脉血压、呼吸频率差异有统计学意义(P<0.05)。镇静评分:A、B、C各组各时点镇静评分与T0时比较差异无统计学意义;A、B、C各组相同时点镇静评分差异无统计学意义(P>0.05)。吗啡总用量:A、B、C各组吗啡总用量差异无统计学意义(P>0.05)。拔管所需时间:B组与A组之间,C组与B、A组之间拔管所需时间差异有统计学意义(P<0.05)。结论:随着右美托咪定给药剂量的增加,血流动力学变化加剧,拔除气管导管时间延长,但没有加深镇静程度。

作者刘庆钱刚张光明

机构地区上海市长宁区中心医院麻醉科

出处《实用医学杂志》 CAS 北大核心 2011年第21期3955-3957,共3页 The Journal of Practical Medicine

关键词呼吸人工右美托咪定镇静血流动力学

分类号 R614 [医药卫生—麻醉学]

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