Comparison Of Sedative Effects Of RASS And Ramsay On ICU Patients With Invasive Ventilation After Abdominal Surgery

Objectives Under the guidance of the eCASH concept,patients with invasive ventilation after abdominal surgery in the intensive care unit（ICU）were treated with analgesia and sedation.Compare the Richmond Agitation and Sedation Scale（RASS）and Ramsay sedation scale（RSS）to provide clinical and theoretical basis for the selection of sedation scores for such ICU patients.Methods A total of 60 patients who underwent invasive ventilation after abdominal surgery admitted to the comprehensive ICU of the Affiliated Hospital of North China University of Science and Technology from June 2018 to June 2019 were selected.Random number table method was used to divide into RASS sedation treatment group（group A）,Ramsay sedation treatment group（group B）,and 30 patients in each group.After entering the ICU,the analgesic treatment was performed first,and the analgesic assessment was performed using the intensive care pain observation tool（CPOT）.Later,the patient was sedated with the eCASH concept,and the dosage of sedative drugs was adjusted according to the RASS and Ramsay ideal sedation scores.Record the general information of the two groups of patients,compare and analyze the recovery time of spontaneous breathing,the time of recovery of consciousness,the dose of remifentanil,the dose of dexmedetomidine,the rate of propofol added,the dose of propofol,sedation time,tube time,one-time extubation success rate,incidence of hypotension,bradycardia incidence,ICU stay time,total hospital stay,30 d mortality,adverse events: delirium,accidental extubation,respiratory depression,Man-machine confrontation,excessive sedation,ventilator-associated pneumonia（VAP）incidence.Record and analyze the two groups after entering ICU 10min（T₀）,1st postoperative day（T₁）,3rd postoperative day（T₂）,5th postoperative day（T₃）,15 minutes before extubation（T₄）,Patient’s arterial oxygen partial pressure（Pa O2）,mean arterial pressure（MAP）,C-reactive protein（Creactive protein,CRP）.Results 1 The general situation of the two groups of patients,such as gender,age,ASA grade,BMI,APACHE II score,and length of operation had no significant differences（P>0.05）.2 The recovery time of spontaneous breathing and recovery time of consciousness did not show significant difference between the two groups of patients after entering ICU（P>0.05）.3 Significant differences could be found in the dose of remifentanil,the dose of dexmedetomidine,the rate of propofol addition,the dose of propofol,the rate of hypotension,and the rate of bradycardia during treatment in the two groups,which in group A were less than group B（P<0.05）.4 The sedation time,tube time and ICU stay time of group A were shorter than that of group B,which statistically difference was significant（P<0.05）.5 The two groups of patients,success rate of onetime extubation,total hospital stay,and 30-day mortality rate had no significant differences（P>0.05）.6 Compared with the adverse events in the two groups: delirium,respiratory depression,human-computer confrontation,hypersedation,and the incidence of VAP in group A were less than group B,with statistical significance（P<0.05）,but the difference in the incidence of accidental extubation between the two groups was turned out to have no statistical significance（P>0.05）.7 Compared with T0 in both groups,Pa O2 decreased significantly at T1～T3 but increased significantly at T4,MAP and CRP increased significantly at T1～T4,with statistical significance（P<0.05）.Between the two groups,the comparison between Pa O2 and CRP at T0 and T1 showed no significant difference（P>0.05）.Compared with group A and B,Pa O2 in group A was significantly higher than that in group B at T2～T4（P<0.05）.The CRP of group A was statistically different from the CRP of group B at T2～T4,during that time,the CRP of group A was lower than group B（P<0.05）.8 There was no statistically significant difference in MAP between the two groups（P>0.05）.Conclusions It is concluded that the use of RASS sedation scores can reduce the use of analgesia and sedation drugs,reduce the incidence of adverse events,and reduce CRP data in patients treated with Ramsay sedation scores,which help to restore postoperative lung function,shorten recovery time and ICU stay time.Patients can perform better and receive clinical treatment,and the RASS sedation score is more conducive to the clinical outcome of such patients and reduces the medical burden of such patients.Figure 3;Table 7;Reference 180...