Comparison of Sedative and Analgesic Effects of Dexmedetomidine and Fentanyl on Patients withMechanical Ventilation After ICU Abdominal Surgery
ZHAO Jian-gang
Department of ICU, Tianjin Jinnan Hospital, Tianjin 300222, China
Abstract:
Objective To explore the effect of dexmedetomidine combined with fentanyl in patients undergoing mechanical ventilation after abdominal surgery in ICU and its effect on sedation and analgesia.Methods From May 2018 to June 2019, 62 patients with mechanical ventilation after abdominal surgery in ICU were selected as subjects and they were randomly divided into the control group (n = 31 cases) and the observation group (n = 31 cases). Both groups were received continuous intravenous pumping of fentanyl. The control group was used midazolam for sedation and analgesia and the observation group was used dexmedetomidine. The analgesic and sedative effects, sedative doses, time to achieve awakening and sedation, hemodynamic level and safety were compared. Results The VAS scores at time points of T2 and T3 in the two groups were ( 2.40±0.31 vs 2.43±0.32 and 2.01±0.12 vs 2.05±0.15 ), and the Ramsay scale scores ( 3.21±0.35 vs 3.20±0.33 and 3.01±0.25 vs. 3.00±0.24 ) were lower than the time points of T1 (VAS score: 2.94±0.69 vs 2.96±0.71;Ramsay scale score: 3.57±0.61 vs 3.58±0.62 ) (P <0.05);The time of dexmedetomidine combined with fentanylin to achieve sedation and analgesia in the observation group was longer ( 34.29±3.56 min )than that of the control group ( 23.63±3.21 ) (t =5.535, P = 0.043). The dosage of sedatives (220.59±15.25 μg ) and the time to achieve awakening ( 3.29±0.69 min ) in the observation group was shorter than those in the control group ( 386.44 ±18.92 μg and 7.56±1.21 min) (t=6.294, 6.092, P=0.023, 0.025 ). The time snack rate of T2 and T2 in both groups (T1 ( 88.47±9.76 ) times / min in observation group, T2 ( 86.41±9.43 ) times/min in observation group; T1 ( 89.53±10.41 ) times / min in control group, T2 ( 87.46±9.58 ) times / min) were higher than that at time T0 (observation group ( 78.78±4.35 ) times / min, control group ( 79.12±4.41 ) times / min) (P <0.05). The T1 and T2 time points MVP of the observation group ( 79.58±5.71, 87.53±6.76mmHg ) were higher than the control group ( 74.12±4.69, 75.26±5.61 mmHg) (t = 9.613, t=7.223, P=0.011, P=0.016). The incidence of adverse reactions during sedation and analgesia in the observation groups was 6.45% and in the control group was 12.90%, which was not statistically signi?cant (χ2=1.214, P= 0.643). Conclusion Dexmedetomidine combined with fentanyl can provide good analgesic and sedative effects in patients who undergone mechanical ventilation after abdominal surgery in ICU. It can shorten the time to achieve awakening and sedation. The hemodynamics is relatively stable. It has high security and is worth promoting.
