The use of dexmedetomidine combined with propofol in mechanically ventilated patients
10.11855/j.issn.0577-7402.2015.06.12
- Author:
Zi-Long HU
1
Author Information
1. Department of Intensive Care Unit, Navy General Hospital of PLA
- Publication Type:Journal Article
- Keywords:
Artificial;
Hypnotics and sedatives;
Midazolam;
Propofol;
Respiration
- From:
Medical Journal of Chinese People's Liberation Army
2015;40(6):479-483
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate and compare the efficacy and safety of midazolam, propofol and dexmedetomidine combined with propofol in sedation for mechanically ventilated patients. Methods Seventy-six patients with mechanical ventilation time >24h in ICU of Navy General Hospital of PLA from Mar. 2012 to Sep. 2014 were randomly divided into midazolam group (n=23), propofol group (n=27) and dexmedetomidine combined with propofol group (n=26), and they were given corresponding drugs for sedation. The proportions in each group which reached the target score of Richmond agitation-sedation scale (RASS) and the nonverbal pain assessment scale (Critical-Care Pain Observation Tool, CPOT) were accounted and recorded, and the positive rate of delirium was assessed with the confusion assessment method in the intensive care unit (CAM-ICU). The mechanical ventilation time and the effectiveness of sedation among the 3 groups were compared, the frequency of adverse cardiovascular events was recorded, and the frequency of controlled ventilation, daily mean arterial pressure as well as the heart rate range were analyzed. Results The proportion of reaching the target score of RASS was higher in dexmedetomidine combined with propofol group (86.54%) than that in midazolam group (69.32%, P<0.05), but there was no significant difference when compared with that in propofol group (79.37%, P>0.05). The proportion of reaching the target score of CPOT was higher in dexmedetomidine combined with propofol group (63.1%) than in midazolam group (51.2%) and propofol group (49.5%, P<0.05), but no significant difference was found between the latter two groups (P>0.05). The positive rate of delirium and the proportion of controlled ventilation were lower, and the time of mechanical ventilation is shorter in dexmedetomidine combined with propofol group than in the other two groups (P<0.05). No significant difference in the proportion of adverse cardiovascular events, mean arterial pressure and heart rate range was found among the three groups (P>0.05). Conclusion The efficacy and safety of dexmedetomidine combined with propofol is higher than the individual use of midazolam or propofol in producing sedation for mechanically ventilated patients.
