Aoki Yoshitaka, Niwa Takuya, Shiko Yuki, Kawasaki Yohei, Mimuro Soichiro, Doi Matsuyuki, Nakajima Yoshiki
Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Biostatistics Section, Clinical Research Centre, Chiba University Hospital, Chiba, Japan.
J Int Med Res. 2021 Mar;49(3):3000605211002683. doi: 10.1177/03000605211002683.
To compare the effects of remifentanil versus fentanyl during light sedation with dexmedetomidine in adults receiving mechanical ventilation (MV) in the intensive care unit.
In this retrospective cohort study, we compared the use of remifentanil versus fentanyl in adults receiving MV with dexmedetomidine sedation. The primary outcome was the proportion of time under light sedation (Richmond Agitation-Sedation Scale score between -1 and 0) during MV.
We included 94 patients and classified 58 into the remifentanil group and 36 into the fentanyl group. The mean proportion of time under light sedation during MV was 66.6% ± 18.5% in the remifentanil group and 39.9% ± 27.3% in the fentanyl group. In the multivariate analysis with control for confounding factors, patients in the remifentanil group showed a significantly higher proportion of time under light sedation than patients in the fentanyl group (mean difference: 24.3 percentage points; 95% confidence interval: 12.9-35.8).
Remifentanil use might increase the proportion of time under light sedation in patients receiving MV compared with fentanyl administration.
比较瑞芬太尼与芬太尼在重症监护病房接受机械通气（MV）的成人患者中与右美托咪定联合进行浅镇静时的效果。
在这项回顾性队列研究中，我们比较了瑞芬太尼与芬太尼在接受MV并使用右美托咪定镇静的成人患者中的使用情况。主要结局是MV期间处于浅镇静状态（里士满躁动-镇静量表评分为-1至0）的时间比例。
我们纳入了94例患者，其中58例分为瑞芬太尼组，36例分为芬太尼组。瑞芬太尼组MV期间浅镇静状态的平均时间比例为66.6%±18.5%，芬太尼组为39.9%±27.3%。在控制混杂因素的多变量分析中，瑞芬太尼组患者的浅镇静时间比例显著高于芬太尼组患者（平均差异：24.3个百分点；95%置信区间：12.9-35.8）。
与使用芬太尼相比，使用瑞芬太尼可能会增加接受MV患者的浅镇静时间比例。
