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Efficacy of dexmedetomidine on mechanical ventilation after uvulopalatopharyngoplasty |
1.Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Department of Respiration, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015 |
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Cite this article: |
YANG Pei1,ZHOU Ying2,ZHANG Xuezheng1, et al. Efficacy of dexmedetomidine on mechanical ventilation after uvulopalatopharyngoplasty[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(2): 131-.
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Abstract Objective: To compare the effect of sedation between dexmedetomidine and midazolam for severe obstructive sleep apnea hypopnea syndrome (OSAHS) after uvulopalatopharyngoplasty (UPPP). Methods: Sixty-four ASA I~II patients of severe OSAHS scheduled for UPPP were randomly allocated into group D (dexmedetomidine, n=32) and group M (midazolam, n=32). The patients of the two groups were sedated with dexmedetomidine or midazolam respectively in the ICU after surgery and Ramsay scores of 3-4 were maintained. Sufentanil were added for analgesia. The supposed hypertension or tachycardia were treated with extra medication. The administration of sedative was stopped after 20 hours stay in ICU and the patients were sent back to ward when the Aldrete score reached 10. Results: The anticipated depth of sedation were acquired in 63 patients and there was a significant difference (P<0.05) demonstrated by 24 patients in group D while 8 patients in group M received no extra medication for hypertension or tachycardia. The level of stress hormone, the mean arterial pressure and heart rate were significantly lower in group D than group M at 2 h (T1), 10 h (T2), 20 h (T3) after entering ICU and before extubation (T4) respectively. The time intervals between medication suspend and departure from ICU were significantly shorter while the degree of satisfaction for the process of sedation were higher in group D than that in group M. Conclusion: Dexmedetomidine has better features of sedation than midazolam for the patients of severe OSAHS with mechanical ventilation after UPPP in ICU.
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Received: 30 May 2014
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[1]Kezirian EJ, Weaver EM, Yueh B, et al. Risk factors for serious complication after uvulopalatopharyngoplasty[J]. Arch Otolaryngol Head Neck Surg, 2006, 132(10): 1091-1098.
[2]Granja C, Gomes E, Amaro A, et al. Understanding posttraumatic stress disorder-related symptoms after critical care: the early illness amnesia hypothesis[J]. Crit Care Med, 2008, 36(10): 2801-2809.
[3]Mahli A, Coskun D, Karaca GI, et al. Target-controlled infusion of remifentanil with propofol or desflurane under bispectral index guidance: quality of anesthesia and recovery profile[J]. J Res Med Sci, 2011, 16(5): 611-620.
[4]Kim JA, Lee JJ, Jung HH. Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty[J]. Laryngoscope, 2005, 115(10): 1837-1840.
[5]Carollo DS, Nossaman BD, Ramadhyani U. Dexme-detomidine: a review of clinical applications[J]. Curr Opin Anaesthesiol, 2008, 21(4): 457-461.
[6]胡霞蔚, 周日永, 王权光, 等. 右旋美托咪啶增强局麻药对坐骨神经的阻滞作用[J]. 温州医科大学学报, 2014, 44(7): 508-511.
[7]Jakob SM, Ruokonen E, Grounds RM, et al. Dexmedetomi-dine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlledtrials[J]. JAMA, 2012, 307(11): 1151-1160.
[8]Pandharipande PP, Pun BT, Herr DL, et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial[J]. JAMA, 2007, 298(22): 2644-2653.
[9]Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial[J]. JAMA, 2009, 301(5): 489-499.
[10]Cortinez LI, Hsu YW, Sum-Ping ST, et al. Dexmedetomi-dine pharmacodynamics: Part II. Crossover comparison of the analgesic effect of dexmedetomidine and remifentanil in healthy volunteers[J]. Anesthesiology, 2004, 101(5): 1077-1083.
[11]Mirski MA, Lewin JJ III, Ledroux S, et al. Cognitive im-provement during continuous sedation in critically ill, awake and responsive patients: the Acute Neurological ICU Sedation Trial (ANIST)[J]. Intensive Care Med, 2010, 36(9): 1505-1513. |
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