Abstract
Application of Remifentanil in Analgesia and Sedation of Mechanically Ventilated Patients in Intensive Care Unit
Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, 1Department of Critical Care Medicine, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China
Correspondence Address:
Xiuming Xi, Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China, E-mail: w64237568@163.com
To observe the analgesic and sedative effect of remifentanil in patients with mechanical ventilation in intensive care unit and to explore the application value of remifentanil in intensive care unit patients with mechanical ventilation. 164 patients were randomly divided into remifentanil combined with dexmedetomidine group (R group), sufentanil combined with dexmedetomidine group (S group) where 82 patients in each group. The patients in the two groups were assessed with the pain observation instrument of intensive care (critical care pain observation tool) for analgesia score and the sedative effect was assessed with the Ramsay scale. The vital signs during the treatment, the time for patients to achieve satisfactory analgesia and sedation, the time for mechanical ventilation, the time for intensive care unit hospitalization and the occurrence of adverse reactions were recorded respectively. Both groups of patients can achieve satisfactory analgesic and sedative effect. Critical care pain observation tool score of patients in the two groups was significantly lower than that before treatment (p<0.05), the percentage of Ramsay assessment grade 3-4 of patients in the R group was significantly higher than that in the S group. Heart rate, map of mean arterial pressure and autonomic respiratory rate of patients in the two groups were significantly lower than that before treatment (p<0.05). There was no significant difference in heart rate between the two groups (p>0.05), map of mean arterial pressure of patients in the R group was significantly higher than that in the S group immediately after treatment (p<0.05); respiratory rate in R group was significantly lower than that in S group (p<0.05). The time of analgesia and sedation (min), mechanical ventilation (H) and intensive care unit hospitalization (H) in group R were significantly shorter than that in group S (p<0.05). The number of hypotension patients in R group was more than that in S group and delirium and agitation were lower than those in S group (p<0.05). Remifentanil combined with dexmedetomidine can rapidly achieve the goal of analgesia and sedation, improve vital signs and shorten the time of satisfactory analgesia and sedation, mechanical ventilation, hospital stay and no serious adverse reactions.
