Tripathi Manoj, Kumar Virendra, Kalashetty Mahendra B, Malviya Deepak, Bais Prateek Singh, Sanjeev Om Prakash
Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Shri B.M. Patil Medical College, Bijapur, Karnataka, India.
Anesth Essays Res. 2017 Oct-Dec;11(4):828-833. doi: 10.4103/aer.AER_48_17.
Mechanical ventilation and sedation are inextricably linked components of critical care that represent, what we do for the patients during their vulnerable course in Intensive Care Unit (ICU).
The aim of this study is to compare the efficacy and safety of midazolam and dexmedetomidine in patients on mechanical ventilator with the help of Bispectral Index (BIS) monitoring and correlation of BIS with Sedation-Agitation Scale (SAS).
Prospective, observational, and comparative study.
In this study, recruited patients were allocated into two groups of 14 patients each. Group A and Group B patients received injection dexmedetomidine and injection Midazolam, respectively. Hemodynamic parameters, time of extubation, duration of mechanical ventilation, and mortality were compared between two groups.
Mean and the standard deviation were calculated. Test of analysis between two groups was performed using unpaired -test. We applied correlation technique, that is, Pearson product-moment correlation coefficient () to assess the correlation between BIS and SAS. It varies from + 1-0 to -1.
Heart rate and blood pressure were more stable and less in Group A than Group B. Duration of mechanical ventilation was found extremely significant between Group A (77.86 ± 5.71 h) and Group B (95.64 ± 17.00 h) ( = 0.001). There was significant difference found in the time of extubation between Group A (21 ± 6.44 h) and Group B (30.4 ± 10.62 h) = 0.008.
It is concluded in this study that sedation with dexmedetomidine resulted in quick extubation and decreased the duration of mechanical ventilation in comparison to midazolam in ICU patients. There was found moderate to high correlation between BIS index and SAS.
机械通气和镇静是重症监护中紧密相连的组成部分，代表了我们在重症监护病房（ICU）为患者在其脆弱病程中所做的事情。
本研究旨在借助脑电双频指数（BIS）监测以及BIS与镇静 - 躁动评分（SAS）的相关性，比较咪达唑仑和右美托咪定在机械通气患者中的疗效和安全性。
前瞻性、观察性和比较性研究。
在本研究中，招募的患者被分为两组，每组14例。A组和B组患者分别接受右美托咪定注射液和咪达唑仑注射液。比较两组患者的血流动力学参数、拔管时间、机械通气时间和死亡率。
计算均值和标准差。两组间的分析检验采用不成对t检验。我们应用相关技术，即Pearson积矩相关系数（r）来评估BIS与SAS之间的相关性。其范围从 +1到0再到 -1。
A组的心率和血压比B组更稳定且更低。A组（77.86 ± 5.71小时）和B组（95.64 ± 17.00小时）之间的机械通气时间差异极为显著（P = 0.001）。A组（（21 ± 6.44小时）和B组（30.4 ± 10.62小时）之间的拔管时间存在显著差异（P = 0.008）。
本研究得出结论，与咪达唑仑相比，在ICU患者中使用右美托咪定镇静可实现快速拔管并缩短机械通气时间。发现BIS指数与SAS之间存在中度至高相关性。
