Application of Remimazolam in Patients with Mechanical Ventilation Sepsis
Objective To investigate the application effect of remimazolam in patients with sepsis undergoing mechanical ventilation,and to analyze its sedative effect.Methods According to the random coin method,80 patients with sepsis who received mechanical ventila-tion in our hospital from April 2021 to April 2023 were divided into remimazolam group(n=27),midazolam group(n=27)and dexme-detomidine group(n=26).The sedative effects(Rass scale score,shallow sedation compliance time,and shallow sedation compliance rate)of the three groups were compared.The mean arterial pressure and heart rate of the three groups were recorded before administra-tion,immediately after administration,1h after administration,and 6 h after administration.The changes of inflammatory stress response(interleukin-1,interleukin-6,cortisol)before administration,24 h and 72 h after administration were recorded,and the occurrence of ad-verse reactions(hypotension,respiratory depression,bradycardia)was counted.Results There were statistically significant differences in Rass scale score,shallow sedation compliance time and shallow sedation compliance rate among the three groups(P＜0.05),and the Richmond agitation and sedation scale score and shallow sedation compliance time in the remifentanil group were the lowest,and the shal-low sedation compliance rate was the highest,followed by dexmedetomidine.The mean arterial pressure and heart rate of the dexmedeto-midine group and the midazolam group at 1 h and 6 h after administration were lower than those before administration(P＜0.05).At 6 h after administration,the mean arterial pressure and heart rate of the remifentanil group were higher than those of the dexmedetomidine group and lower than those of the midazolam group(P＜0.05).The levels of interleukin-1,interleukin-6 and cortisol at 24 h and 72 h af-ter administration were higher than those before administration(P＜0.05),but the levels at 72 h after administration were lower than those at 24 h after administration.The cortisol levels of the three groups of patients at 24 h and 72 h after administration were statistically sig-nificant(P＜0.05),and the remimazolam group was lower than the dexmedetomidine group and the midazolam group.There were signifi-cant differences in the levels of interleukin-1 and interleukin-6 among the three groups at 72 h after administration(P＜0.05),However,there was no significant difference between remimazolam group and dexmedetomidine group(P＞0.05),and both were lower than mid-azolam group(P＜0.05).There were statistically significant differences in the incidence of respiratory depression and bradycardia among the three groups(P＜0.05),but the incidence of bradycardia in the remimazolam group was the lowest,and the incidence of respiratory de-pression was second only to that in the dexmedetomidine group.The incidence of hypotension in remimazolam group was the lowest,but there was no statistical difference among the three groups(P＞0.05).There was no significant difference in the incidence of hypotension(P＞0.05).Conclusion Compared with dexmedetomidine and midazolam,remimazolam has the advantages of faster onset of shallow se-dation,higher compliance rate,better hemodynamic stability and lower incidence of adverse reactions in patients with sepsis undergoing mechanical ventilation.However,it is consistent with the anti-inflammatory effect of dexmedetomidine and is superior to midazolam.
万方数据
维普
