Clinical Observation Of Dexmedetomidine Hydrochloride On Sedation And Analgesia Of ICU Patients

Objective：To observe the effect of the level of sedation and analgesia andhaemodynamics, respiratory function, inflammatory response, delirium in ICUpatients used of dexmedetomidine.Methods：40surgical patients who suffered from fracture in our intensive care unit(Male25，Female15,20-67years old) in need of sedation and analgesia. Theywere randomly divided into two groups:①sedation with dexmedetomidine（group I）②sedation with midazolam（group I).All patients treated withSedation and Analgesia with the above sedation drugs combined withmorphine and intake dose was adjusted to maintain theRamsay score of3-4.Record the time needed to achieve the target duration of sedation and wake upafter withdrawal,pain scores and the amount of extra dose of sedation andanalgesia drugs; Record the HR,SBP, DBP,RR and SPO2atpre-administration (T0),1hour after administration(T1),3hour afteradministration (T3),6hour after administration (T6) and12hour afteradministration (T12); Every half-hour assessment of patients with deliriumbyCAM-ICU after treatment and Record delirium duration； Blood sampleswere obtained for analysis levels ofTNF-a and IL-6at pre-administration (T0)and12hour after administration (T12)； Results：1.There was no significant difference in age, gender proportion, weight,APACHE II score between two groups (P>0.05)2.The pain score evaluated in group I (评分) was lower than group II(评分)(P<0.05)；The dosage morphine, groupI was lower than group II (P<0.05).3. There was no significant difference in the HR,SBP, DBP,RR andSPO2at the time points ofpre-administration (T0) among two groups(P>0.05).The HR, SBP, DBP and RR at thetime points of1hour afteradministration (t1)，3hour after administration (T3)，6hour afteradministration (T6)， and12hour after administration (T12) was lowerthanpre-administration (T0)(P<0.05). The fluctuations of HR,RR,SBP andDBP at thetime points of1hour after administration (t1)，3hour afteradministration (T3)，6hour after administration (T6)，and12hour afteradministration (T12) group I was smaller thangroup II (P<0.05).Andthere was no significant difference in the SPO2at the time points ofpre-administration (T0) and after administration among two groups.4. The patients in group I has lower delirium incidence and shorterdelirium duration than patients in group II (P<0.05)5.The levels of TNF-a and IL-6at the time points of12hour afteradministration (T12) was higher than pre-administration(T1)in eachgroup.The levels of TNF-α and IL-6at the time points of12hour afteradministration (T12) group I was lower than group II (P<0.05).Conclusion： Dexmedetomidine can offer a good sedation level and also a mildanalgesic effect.Rapid recovery as soon as withdrawal and there’s nosignificant drug accumulation.It can offer a sedation with mild respiratorydepression,stable hemodynamic,less delirium and low cardiovasculary adverseevents’ occurrence.In addition， dexmedetomidine has a effect of anti-inflammation.