The Clinical Study Of The Prophylaxis Effect Of Target Controlled Infusion With Propofol On Severe Patients With Stress Response In Intensive Care Unit

Objective To study the sedation effect of target controlled infusion with Propofol onSevere Patients in Intensive Care Unit, and study it's prophylaxis effect on stress responseor stress ulcer developed in these patients.Method 120 patients underwent the acute physiology and chronic health evaluation(APACHE), with APACHE II≥16, were randomly divided into three groups: Group A wascontrasting group, use Midoxolam and Fentanyl for pain controlling and sedation withmicro pump infusion system; Group B was the group of Propofol and Fentanyl with micropump infusion system; Group C was the group of Propofol and Fentanyl with targetcontrolled infusion(TCL), controlling the Patients' Ramsay Score between 2 to 5. HR andMAP were monitored before infusion, 12hours after infusion and 24 hours after infusion;venous blood samples were taken during these time, and the concentration of GLU, CORand ACTH were measured each time; Gastric fluids were taken and PH were measuredeach time.Result GLU, COR and ACTH were decreased obviously in three groups after sedationtherapy(in 24 hours), have significant difference compare to the data collected beforeinfusion(P<0.05). PH in gastric fluids were gradually increased over time in three groupsafter sedation therapy(in 24 hours), have significant difference compare to the datacollected before infusion(P<0.05). GLU, COR, ACTH and PH in gastric fluids have nosignificant difference in group B and group C, compared to group A(P>0.05). MAP andHR have no significant difference before and after infusion in group A(in 24 hours); MAPand HR were decreased and have significant difference before and after infusion in groupB(P<0.05); MAP and HR have no significant difference before and after infusion in groupC(in 24 hours)(P>0.05)Conclusion Effective sedation and analgesia therapy can relieve the stress response,increase PH in gastric fluids, decrease the risks and prevent the development of stress ulcerin critical patients. Compared to the traditional continuing infusion methods, TCLtechnique can provide more stable blood concentration, increase the agility andcontrollability of sedation and effectively avoid the suppression of the cardiovascularsystem.