| Objective:To study the safety and sedative effect of propofol and midazolam on patients with restless after UPPP surgery,offering such restless patients base on clinical treatment of sedation.Methods:60 restless patients after UPPP surgery in the ICU(postoperative pain pump were geiven),All 60 patients with severe OSAHS were treated by surgery uvulopalatopharyngoplasty(UPPP) and Nasotracheal intubation was performed.They were randomly divided into two groups,namely propofol group and midazolam group(P group and M group),ASAâ… -â…¡.Propofol group was 30 cases(male,aged 24-58 years old,weight 75-95 kg) The patients in this group were induced intravenously with propofol 1.5mg/kg as a loading dose,and infused continuously with pump thereafter,the infusion rate was 0.3-4.8 mg/kg/h.midazolam group was 30 cases(male,aged 21-57 years old,weight 68-92kg),The patients in this group were injected intravenously with midazolam 0.05 mg/kg as a loading dose,and infused continuously with pump thereafter,the infusion rate was 0.04-0.2 mg/kg/h.The dose infused was adjusted according to Ramsay classification standard.The sedative level was kept in the Ramsay sedative levelⅢ～Ⅵ.The blood pressure,heart rate, respiration rate,arterial oxygen saturation and blood gas were monitored before, during the treatment with drugs and after tracheal extubation,blood pressure,heart rate,respiration rate,arterial oxygen saturation before(T1) and after using the drugs 10min(T2),1h(T3),2h(T4),6h(T5) and after tracheal extubation(T6) were recorded,Blood gas analysis indicators,PaO2,PaCO2,pH before(T1) and after using the drugs 2h(T4) and after tracheal extubation(T6) were recorded.drug onset time,average drug infusion rate to Ramsay3-4.The recovery time after stopping infusion of the drugs as well as re-sleep,low blood pressure,emesis and forgetting were also recorded.Results:(1)There was no significant difference in age,weight,sex,surgery time, anesthesia time of the two groups(P＞0.05).(2)There was significant differences between T1 and T2 with blood pressure in propofol group(P＜0.05),blood pressure decreased significantly comparing with T1.T1 and T3,T4,T5,T6,blood pressure showed no significant difference(P＞0.05),heart rate,pulse oxygen saturation,PaO2, PaCO2,pH value between T1 and other different time points showed no significant difference(P＞0.05).comparing with T1,the respiratory rate in T2 reduced significantly(P＜0.05).T1 and T3,T4,T5,T6 showed no significant difference(P＞0.05).(3) In midazolam group,blood pressure,heart rate,pulse oxygen saturation,PaO2,PaCO2,pH value between T1 and after using the drugs at different time points showed no significant difference(P＞0.05).T2,T3,the respiratory rate reduced significantly(P＜0.05),and with T4,T5,T6 showed no significant difference(P＞0.05).(4)Significant difference was found in the onset time,recovery time after stopping of two groups(P＜0.05).The average drug infusion rate to Ramsay2-3,P group was 2.265±0.745 mg/kg/h,M group was 0.085±0.045 mg/kg/h. re-sleep,low blood pressure and emesis showed significant difference(P＜0.05). Forgotten proportion was significantly different(P＜0.05).Two sedation score had no significant difference(P＞0.05).Conclusion:1.As a calmative,propofol and midazolam infused continuously with pump thereafter is safe to postoperative patients with severe OSAHS in duration of endotracheal intubation.2.Propofol and midazolam infused continuously with pump thereafter,can achieve a satisfactory level of sedation to postoperative patients with severe OSAHS in duration of endotracheal intubation.3.Onset time and recovery time of Propofol was shorter than that of the midazolam group,hypotension rate of Propofol group was higher than that of midazolam group,re-sleep and emesis of Midazolam group was higher than that of propofol group,However,Anterograde forgetting function of Midazolam was better.
|
PDF Full Text Request