The Comparison Of Sedative Effects Of The Different Sedative Medicine On Patients On Mechanical Ventilation In Intensive Care Unit

Objective:To discuss the application of dexmedetomidine, propofol, midazolam and propofol combined with midazolam on sedation of patients on mechanical ventilation in ICU.Methods:Select 120 patients receiving mechanical ventilation in ICU and randomly divide them into four groups of dexmedetomidine(Group D), propofol(Group P), midazolam(Group M) and propofol combined with midazolam(Group M+P). Then, provide them with conventional pumping of sufentanil and keep Ramsay 2-4 score, continuously monitor and record respirator parameters, electrocardiogram, heart rate, blood pressure, arterial oxygen saturation and carry out blood gas analysis as well. And then, observe the wake-up time,extubation period and mechanical ventilation(MV) period, bradycardia and incidence of delirium after discontinuation of the drugs and add up the period the patients staying in ICU and cost for sedation and total treatment costs during the period.Results:(I) The comparison of the weak-up periodThere are statistically significant differences(P < 0.001) between the comparison of the weak-up period of 4 groups. The weak-up period are significantly shorter in group D than that in group M and group M+P(P < 0.05); Compared with that of group M, the weak-up period in group P and M+P are reduced(P < 0.05).Compared with that of group P,the weak-up period in group M+P is longer(P < 0.05).while no statistically significant difference is seen between that of D and P(P > 0.05).(II) Period between Drug Withdrawal and ExtubationThere are statistically significant differences(P < 0.001) between the comparison of the extubation of 4 groups. The extubation period of group D is significantly shorter than that of the other three groups(P < 0.05).Compared with that of group P,the extubation period in group M+P and group M is longer(P < 0.05).while no statistically significant difference is seen between that of M and M+P(P > 0.05).(III) Incidence Rate of Low Blood PressureThere are statistically significant differences(P < 0.05) between the comparison of the incidence rate of low blood pressure of the 4 groups.The incidence rate of low blood pressure in group P and group M+P is higher than that of the other two groups(P <0.05).No statistically significant difference is seen between that of D and M(P > 0.05),and no statistically significant difference is between that of P and M+P(P > 0.05).(IV) Incidence Rate of BradycardiaThere are statistically significant differences(P < 0.05) between the comparison of the incidence rate of bradycardia of the 4 groups.The incidence rate of bradycardia of group D is significantly higher than that of the other three groups(P < 0.05),while no statistically significant difference is between that of M,P and M+P(P > 0.05).(V) Incidence Rate of DeliriumThere are statistically significant differences(P < 0.05) between the comparison of the incidence rate of delirium of the 4 groups.The incidence rate of delirium of group M is significantly higher than that of the other three groups(P < 0.05),while no statistically significant difference is between that of D,P and M+P(P > 0.05).(VI) Length of Stay in ICUThere are statistically significant differences(P < 0.05) between the comparison of the length of stay in ICU of the 4 groups. The length of stay in ICU of the group D is significantly shorter than that of the other three groups(P < 0.05).Compared with that of group P,the length of stay in ICU in group M and group M+P is longer(P < 0.05).while no statistically significant difference is between that of M and M+P(P > 0.05).(VII) Cost of Sedation during Stay in ICU and Total Treatment CostThere are statistically significant differences(P < 0.001) between the comparison of the cost of sedation during stay in ICU and total treatment cost of the 4 groups, the cost of sedation for group M+P cab be decreased than that of the other three groups(P < 0.05),and the total treatment cost during stay in ICU of group D can be significantly reduced thanthat of the other three groups(P < 0.05) as well.(VIII) Dosage of SufentanilThere are statistically significant differences(P < 0.001) between the comparison of the dosage of sufentanil of the 4 groups.The dosage of sufentanil for group D patients is significantly less than that for the other three groups(P < 0.05),while no statistically significant difference is between that of M,P and M+P(P > 0.05).Conclusion:Dexmedetomidine has better effects on sedation of ICU patients on mechanical ventilation and the patients are easy to be woke up and keep quiet with short wake-up period and extubation period, thus, the MV period is shortened; besides, it helps reduce dosage of sufentanil to a certain degree to decrease the stay of the ICU patients thus reduces the total treatment costs during the period staying in ICU.