Cevik F, Celik M, Clark P M, Macit C
Medical Department, Abbott Pharmaceuticals, Meral Plaza, Umraniye, Istanbul, Turkey.
Pain Res Treat. 2011;2011:650320. doi: 10.1155/2011/650320. Epub 2011 Jul 2.
Optimal sedation and analgesia are of key importance in intensive care. The aim of this study was to assess the quality of sedoanalgesia and outcome parameters in regimens containing midazolam and either fentanyl or remifentanil. A prospective, randomized, open-label, controlled trial was carried out in the ICU unit of a large teaching hospital in Istanbul over a 9-month period. Thirty-four patients were randomly allocated to receive either a remifentanil-midazolam regimen (R group, n = 17) or a fentanyl-midazolam regimen (F group, n = 17). A strong correlation between Riker Sedation-Agitation Scale (SAS) and Ramsey Scale (RS) measurements was observed. Comparatively, remifentanil provided significantly more potent and rapid analgesia based on Behavioral-Physiological Scale (BPS) measurements and a statistically nonsignificantly shorter time to discharge. On the other hand, remifentanil also caused a significantly sharper fall in heart rate within the first six hours of treatment.
在重症监护中，最佳的镇静和镇痛至关重要。本研究的目的是评估含咪达唑仑和芬太尼或瑞芬太尼的方案中的镇静镇痛质量及结果参数。在伊斯坦布尔一家大型教学医院的重症监护病房进行了一项为期9个月的前瞻性、随机、开放标签、对照试验。34例患者被随机分配接受瑞芬太尼-咪达唑仑方案（R组，n = 17）或芬太尼-咪达唑仑方案（F组，n = 17）。观察到里克尔镇静-躁动量表（SAS）和拉姆齐量表（RS）测量之间有很强的相关性。相比之下，基于行为-生理量表（BPS）测量，瑞芬太尼提供了显著更强效和快速的镇痛效果，且出院时间在统计学上无显著差异，但更短。另一方面，瑞芬太尼在治疗的前6小时内也导致心率显著下降。
