The Observation Of The Analgesic And Sedative Effect Of Dexmedetomidine Combined Sufentanyl In Patients With AECOPD Need Of Mechanical Ventilation

Objective:To survey the effect of dexmedetomidine combined sufentanyl in patients with AECOPD need of mechanical ventilation for clinical application.Method:This research selects 90 cases of patients who were diagnosed with AECOPD from December 2014 to December 2016 in Intensive Care Unit with,and mechanical ventilation was needed.According to different use is calming and sedative drugs,90 patients were randomly divided into sufentanyl group(group S),midazolam combined sufentanyl group(group MS),dexmedetomidine combined sufentanyl group(group DS)on average.(1)Compare of three groups of patients admitted to hospital with general information,including age 、 sex 、Pa CO2、Body Mass Index(BMI)、APACHEⅡ score;(2)Record the change of vitl signs and catecholamine concentration before and after tracheal intubation、 1 hour after analgesia calm;(3)Record the change of breathing indicators before analgesia calm、1 hour and 48 hours after analgesia calm;(4)Record the number of cough and delirium、the time of mechanical ventilation and ICU stay and the sufentanyl dosage each hour.Results:(1)Comparing of three groups of patients with general information,there was no statistically significant difference(P > 0.05).(2)Record vitl signs and catecholamine concentration Contrasting in group:each index after tracheal intubation were significantly higher than those before tracheal intubation(P <0.05);comparing the index of before and after tracheal intubation,Each index of 1 hour after analgesia calm declined obviously(P<0.05).Contrasting between groups:each index were no significantly different between before and after tracheal intubation(P > 0.05);the index of group MS and group DS were significantly lower than those of group S(P<0.05);Except the mean artery pressure,the index of group DS were significantly different from those of group MS(P<0.05).(3)Record breathing indicators Contrasting in group:comparing each index between before analgesia calm and 1 hour after analgesia calm,the resistance of air way(Raw)、the work of breathing(WOB)were significantly different of any two groups;comparing each index of before analgesia calm and 1hour after analgesia calm,the breathing indicators were significantly different 48 hours after analgesia calm(P<0.05).Contrasting between groups:each index were not significantly different before analgesia calm(P>0.05);comparing each index 1 hour after analgesia calm,the WOB of group MS and group DS were clearly different from those of group S,and each index of group MS and group DS were not significantly different;48 hours after analgesia calm,the Raw、Cst、WOB of group MS and group DS were clearly different from those of S group,and the Raw、Cst、WOB were significantly different between group MS and group DS(P<0.05).(4)Record the number of cough and delirium During the period of sufentanyl,the number of cough of group DS was obviously lower than that of group MS and group S(P<0.05);any two groups of the number of delirium was clearly different(P<0.05).(5)Comparing the time of mechanical ventilation and ICU stay、and the sufentanyl dosage each hour,each index of group DS were lower than those of group MS and group S,and those index of group MS were clearly different from those of group S.Conclusion:1.Dexmedetomidine combined sufentanyl can effectively reduce the stress response,the catecholamine release;2.Dexmedetomidine can promote lung function recovery,and has lung protective effects;3.Dexmedetomidine can reduce the number of cough and delirium of patients with mechanical ventilation;4.Dexmedetomidine can significantly reduce the dosage of the sufentanyl;5.In reducing invasive mechanical ventilation time and ICU length of hospital stay,dexmedetomidine was better.