| Object:To explore the effect of dexmedetomidine hydroch on patients needing to be calm down in the p ostoperative adjuvant treatment of mechanical ventilation in ICU. Apply dexmedetomidine hydroch injection and Midazolam injection to the patients in the postoperative adjuvant treatment of mechanical ventilation respectively and observe the changes of heart rate(HR), respiration(R), mean arterial blood pressure(MAP), oxyhemoglobin saturation(SaO2) and sedation-related score, so as to evaluate the safety and sedation effect of dexmedetomidine hydrochin injection.Method:prospective study method is used in this study. All patients were hospitalized in ICU wards at Second Affiliated Hospital of Dalian Medical University between January 2014 and December 2014. According to the selected index and eliminate index for grouping research object.The whole experimental research implementation process is strictly following the rules of the experimental rules and regulations, the complete experiment method and plan are approved by the ethics committee of the hospital. And detailed announcements is made to the patients and the family members about the medical projects and methods that brought to the selected patients. AllProcess is recognized by the patients and their family members. Based on randomized controlled principle, the selected patients is divided into two groups according to the orders that they enter to the ICU: dexmedetomidine hydrochin treatment group and Midazolam treatment group. Each group contains 40 patients, among the 40 patients in dexmedetomidine hydrochin treatment group, there are 34 patients that meet the standard, we name it A group, Among the 40 patients in Midazolam treatment group, there are 31 patients that meet the standard, we name it B group.Through the comparison of the indexes above, there are no statistically difference between the two groups(P>0.05). Record the changes of Ramsay scale, average arterial pressure, respiratory rate, SPO2, agitation and sedation Ramsay scale, basic pain scale(BPS), visual analogue scale(VAS)and Riker stir-sedation scale(SAS) before and after the application of the medicine of the two groups to evaluate the sedation effect of the medicine in the two groups and the effect on respiration and hemodynamics. SPSS 16.0 statistics software is used in this study, corresponding statistical methods are used to conduct all kinds of counting and measuring data, P<0.05 is regarded as statistically significant.Result:through the treatment of A group with dexmedetomidine hydrochin, the Ramsay scale ranges from 3-4, it means a satisfactory sedation effect, the extubation can be executed on time and no drug-stop treatment is needed before extubation. During the drug application, no apparent blood pressure and heart rate decline appears. Through the treatment of B group with Midazolam, the Ramsay scale ranges from 4-5, which also means a satisfactory sedation effect, the extubation can be executed on time,however, the sedation drug should be withdrawn one hour before extubation. During the drug application, most patients appear stirring, the Ramsay scale of 26 patients of them declines by an average 1-2.All the patients has a respiration and blood pressure decline during the drug application, 2 of which had a temporally drug-withdrawal and corresponding measures due to the blood pressure decline, and the blood pressure is back to normal afterwards and the drug application can be continued. All the 65 selected patients appears different degrees of transient heart rate increase and blood pressure increase, and the condition can turn back to normal after the extubation. During the treatment, there is no decline in the aspect of SPO2 of the patients.Conclusion:dexmedetomidine hydrochin injection has a good effect of sedation on the postoperative patients, what is more, it can reduce the incidence of adverse reaction before and after the mechanical ventilation effectively and maintain smooth respiratory and hemodynamic stability,No significant inhibition of respiration. |
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