Effect Of Dexmedetomidine On Sedation In Patients With Moderate Head Trauma

Objective : To evaluate the efficacy and efficacy of dexmedetomidine in the treatment of sedation in patients with moderate traumatic brain injury,analyze its safety and efficacy,and provide scientific guidance for the treatment of sedation in patients with moderate craniocerebral trauma.Methods : According to the inclusion and exclusion criteria,patients with moderate craniocerebral trauma(8<GCS<12)were required to be screened for subjects with respiratory failure due to pulmonary infection in an intensive care unit in our hospital.The interception time was from September 2015 to September 2016,and a total of 62 patients were included in the study.The subjects were grouped by random number table method and divided into study group and control group,31 cases in each group.The control group was sedated with propofol.The patients in the study group were given dexmedetomidine for sedation,and the sedation effect was compared between the two groups.Observed indicators include:(1)The changes of heart rate,mean arterial pressure,respiratory rate and other vital signs of patients in the two groups were compared 10 min before and 6h after the tre atment;(2)The differences in blood gas index levels(including blood oxygen partial pressure,blood carbon dioxide partial pressure,and blood oxygen saturation)between the two groups were compared 10 min before and 6h after the treatment.(3)Will calm levels in patients with RASS score between 1-0,compared two groups of pa tients after time of arrival in target level of sedation,awakened after discontinuation of time and drug 1-12 hours need calm intervention number(the number of pump sp eed control);(4)BPS score of two groups of patients 6h after medication;(5)The incidence of adverse events(including delirium,decreased heart rate,decreased blood pressure,etc.)was compared between the two groups..The data used in this study were analyzed by SPSS21.0 statistical software.For the percentage of the count data(%),the results of the comparisons between the data were tested using?2,with P <0.05 as the difference.(±s),the results of the comparison between the data using t to test,to P <0.05 for the difference was statistically significant.Results:1.There was no significant difference in heart rate,mean arterial pressur e,respiratory rate and other vital signs between the two groups(P > 0.05).The heart r ate,mean arterial pressure and respiratory rate of patients in both groups decreased t o different degrees after the treatment.Comparison between groups,group the patient s vital signs drop is relatively small,6 h after drug treatment group on the influence o f heart rate,mean arterial pressure,respiratory frequency conditions are less than th e control group,compare the difference was statistically significant(P < 0.05).2.There was no significant difference between the two groups in the compariso n of various blood gas indexes of PaO2,PaCO2 and SaO2 before medication(P > 0.05).6 h after drug PaO2 of two groups of patients have different degree of decline,Pa O2 and group patients drop is relatively small,the team with the control group after t wo groups of patients with PaCO2 have different degree rise,compared with PaCO2 t eam rise is relatively small,compare the difference was statistically significant(P < 0.05).3.Two drugs both can make calm levels in patients with RASS score betwee n-4-0,and two groups of patients after medication to the target sedation level close t o the time,no statistical differences between the two indicators through inspection.H owever,the number of sedation interventions required by the study group within 1-12 hours of drug use was lower than that of the control group,which could be awakene d quickly after the cessation of drug use,and the difference was statistically significan t(P < 0.05).4.The BPS scores of patients in the study group were significantly lower than those in the control group at 6 h after treatment(P<0.05).5.The incidence of adverse events such as delirium,slowed heart rate,decreased blood pressure,and elevated blood pressure in the study group was significantly lower than that in the control group.The difference was statistically significant(P<0.05).Conclusion: The sedation of dexmedetomidine in patients with craniocerebral trauma is superior to propofol in sedation.Drugs have little influence on heart rate,mean arterial pressure,respiratory frequency and other vital signs and blood gas index effect is small,need fewer calm intervention,sedative and analgesic effect is relative ideal,ease the pain of patients,reduce the incidence of adverse events,safe and reliable,and is worth popularizing in clinical application,but wake up late.