Bedi Amit, Murray James M, Dingley John, Stevenson Michael A, Fee J P Howard
Royal Group of Hospitals, Belfast, Northern Ireland.
Crit Care Med. 2003 Oct;31(10):2470-7. doi: 10.1097/01.CCM.0000089934.66049.76.
Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative.
Double-blind, randomized study.
Tertiary-level intensive care unit.
Twenty-one patients admitted to an intensive care unit following elective thoracic surgery.
A standard intensive care sedation regimen (intravenous propofol at 0-5 mg.kg-1.hr-1 and alfentanil 30 microg.kg-1.hr-1) was compared with a xenon sedation regimen delivered using a novel bellows-in-bottle delivery system. MEASUREMENTS AND MAIN RESULTS Each sedative regimen was continued for 8 hrs. The hemodynamic effects, additional analgesic requirements, recovery from sedation, and effect on hematological and biochemical variables were compared for the two sedation regimens. All patients were successfully sedated during the xenon regimen. The mean +/- SD end-tidal xenon concentration required to provide sedation throughout the duration of the study was 28 +/- 9.0% (range, 9-62%). Arterial systolic, diastolic, and mean pressures showed a greater tendency for negative gradients in patients receiving the propofol regimen (p <.05, p <.1, and p <.01, respectively). Recovery following xenon was significantly faster than from the standard sedation regimen (p <.0001). Hematological and biochemical laboratory markers were within normal clinical limits in both groups.
Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect.
重症监护环境中使用多种镇静方案，但无一完全没有不良反应。氙是一种具有镇静和镇痛特性的惰性气体。它已成功用作全身麻醉剂，具有许多理想特性，其中对心肌影响最小。理论上，氙对某些危重症患者可能提供无不良反应的镇静作用。本研究的目的是评估使用氙作为重症监护镇静剂的可行性。
双盲、随机研究。
三级重症监护病房。
21例择期胸外科手术后入住重症监护病房的患者。
将标准重症监护镇静方案（静脉注射丙泊酚0 - 5mg·kg⁻¹·hr⁻¹和阿芬太尼30μg·kg⁻¹·hr⁻¹）与使用新型瓶中波纹管输送系统的氙镇静方案进行比较。
每种镇静方案持续8小时。比较两种镇静方案的血流动力学效应、额外镇痛需求、镇静恢复情况以及对血液学和生化指标的影响。在氙方案期间所有患者均成功镇静。在整个研究期间提供镇静所需的平均±标准差呼气末氙浓度为28±9.0%（范围9 - 62%）。接受丙泊酚方案的患者动脉收缩压、舒张压和平均压显示出更大的负梯度倾向（分别为p <.05、p <.1和p <.01）。氙镇静后的恢复明显快于标准镇静方案（p <.0001）。两组血液学和生化实验室指标均在正常临床范围内。
氙在我们的患者组中提供了满意的镇静效果。耐受性良好，血流动力学影响最小。从该药物的恢复极其迅速。我们已证明在重症监护环境中使用氙的可行性，且无不良反应。
