Effect Of Dexmedetomidine On Heart Rate Variability In Severe Patients With "Yingwei Disharmony"

Objective:This study aims to further verify the effect of dexmedetomidine on HRV(heart rate variability)in critically ill patients,to explore whether the effect of Western sedation on HRV and Yingwei function of traditional Chinese medicine is the same,and to provide clinical data to further explore the correlation between autonomic nervous function and Yingwei function.Methods:A retrospective experimental design was used in this study.Severe patients who met the inclusion criteria were selected and divided into three groups according to the use of sedatives:dexmedetomidine group,midazolam group and blank control group(without sedatives).There were 30 patients in each group,with a total of 90 patients.The changes of each index in patients were observed before and after the experiment for 1 h.Clinical observation indicators:changes of HRV(ASDNN,CN,SDANN,RMSSD),TCM Yingwei function score,basic vital signs(blood pressure,heart rate,respiratory rate)before and after treatment in each group.The changes of indexes before and after sedation were compared between groups.Results:HRV analysis:1.Before treatment:there was no significant difference in HRV among the three groups before treatment(all P>0.05).(2)After treatment:HRV in the dexmedetomidine group and midazolam group after treatment was significantly different from that before treatment(all P<0.01),and there was no significant difference between the HRV group before and after treatment in the blank control group(all P>0.05).There was no significant difference in HRV between dexmedetomidine group and midazolam group after treatment(all P>0.05).There were statistical differences in ASDNN and SDANN between the two groups compared with the blank control group(all P<0.05),and there were no statistical differences in SDDNN and RMSSD(all P>0.05).The fluctuation of HRV change in dexmedetomidine group before and after treatment was statistically different from that in midazolam group and blank control group(all P<0.05),and the HRV change in dexmedetomidine group and midazolam group was statistically different from that in blank control group(all P<0.05).Analysis of blood pressure,heart rate and respiratory rate:1.Before treatment,there were no significant differences in blood pressure,heart rate and respiratory rate among the three groups(all P>0.05).(2)After treatment,there were significant differences in blood pressure,heart rate and respiratory rate between dexmedetomidine group and midazolam group after treatment(P<0.01).The blood pressure and respiratory rate of the blank control group were not significantly different from those before treatment(all P>0.05),and the heart rate was statistically different(P<0.05).After treatment,there were statistical differences in blood pressure,heart rate and respiratory rate between dexmedetomidine group and midazolam group,and there were statistical differences in heart rate between dexmedetomidine group and midazolam group,but no statistical differences in blood pressure and respiratory rate.Yingwei Function Score:1.Before treatment,there was no significant difference in Yingwei Function Score between the three groups(all P>0.05).(2)After treatment:after treatment,the scores of the three groups of patients had statistical difference(P<0.05),after treatment,the scores of the three groups had statistical difference(P<0.05),and there was no statistical difference between the dexmedetomidine group and the midazolam group(P>0.05).There were statistical differences between the dexmedetomide group and the blank control group(P<0.05).There were statistical differences in fluctuation of battalion and health function scores among the three groups(P<0.01),and there were significant statistical differences between the dexmedetomidine group and the midazolam group(P<0.01),and there were significant statistical differences between the dexmedetomidine group and the midazolam group compared with the blank control group(P<0.01).Correlation analysis:There was a weak correlation between the overall HRV-Yingwei functional score of 90 patients before and after treatment(all P<0.05).Conclusion:Dexmedetomidine and midazolam can improve HRV and Yingwei function in critically ill patients with battalion-guard disorder,and the effect of dexmedetomidine is better than that of midazolam.There was a correlation between HRV and camp-health function.