| Abstract:Objective:To observe the effect of sedation on stress involved in mechanic ventilation in patients with respiratory failure and evaluate therapeutic effect of two sedative methods. Methods:30 respiratory failure patients treated with tracheal intubation and mechanical ventilation were randomly divided into control(n=10, C), midazolam(n=10, M) and midazolam+fentanyl(n=10, M+F). The blood gas analysis(including oxygena-tion index), plasma catecholamine concentrations(including adnephrine, norepinephrine and dopamine), blood pressure(BP) and heart rate(HR) were measured before tracheal intubation and 30min,3h after tracheal intubation. The total dosages of midazolam during 24h were calculated. Results: Compared with pre-tracheal intubation, plasma catecholamine concentrations, HR and BP 30min after tracheal intubation in group C were higher significantly than that before tracheal intubation (P<0.05), There were no significant differences in oxygenation index(P>0.05); Plasma catecholamine concentra-tions,HR and BP 30min,3h after tracheal intubation in group M and M+F were lower significantly than that before tracheal intubation(P<0.05), oxygenation index was also improved significantly(P< 0.05). Furthermore, plasma catecholamine concentrations, HR and BP 30min after tracheal intubation in M and M+F group were lower significantly than that in C group (P<0.05); However, there were no significant differences in plasma catecholamine concentrations, HR and oxygenation index 30min,3h after tracheal intubation between M and M+F group (P>0.05), but BP in M+F group were higher than that in M group (P<0.05),the total dosages of Midazolam during 24h in M+F group were lower than that in M group (P<0.05). Conclusion:â‘ Tracheal intubation and mechanical ventilation can cause stress and enhance the levels of plasma catecholamine;â‘¡Sedative therapy can effectively prevent the stress induced by tracheal intubation and mechanical ventilation, improve oxygenation.â‘¢Combined sedative treatment of midazolam and Fentanyl can obviously reduce the dosages of midazolam and the change of hemodynamic parameters, therefore, combined sedative treatment of midazolam and Fentanyl is more beneficial to critical patients with respiratory failure. |
