Effects of Angong Niuhuang Pill combined with Fentanyl and Midazolam on analgesia and sedation in critically ill patients on mechanical ventilation
Objective To explore the effects of Angong Niuhuang Pill combined with fentanyl and midazolam on analgesia and sedation in critically ill patients on mechanical ventilation,aiming at providing a clinical treatment reference.Methods From January 2021 to December 2023,100 critically ill patients on mechanical ventilation admitted to the No.4 People's Hospital of Hengshui were selected.Patients were randomly assigned to conventional group traditional Chinese medicine (TCM) group,50 patients in ench group.The conventional group or received fentanyl and midazolam for analgesia and sedation,and the TCM group received Angong Niuhuang Pill combined with fentanyl and midazolam.The Critical Care Pain Observation Tool (CPOT) and Richmond Agitation-Sedation Scale (RASS) scores were compared at 24,48,and 72 hours after adminis-tration and at weaning.Fentanyl and midazolam consumption was also compared between the two groups.Results At 24 hours after administration,no significant difference was observed in CPOT scores between the two groups (P>0.05).At 48 and 72 hours after administration,both groups had lower CPOT scores than at 24 hours,with the TCM group showing significantly lower scores than the conventional group (P<0.05).At 48 and 72 hours and at weaning,both groups had low-er RASS scores than at 24 hours,with the TCM group showing significantly lower scores than the conventional group (P<0.05).The TCM group used significantly less fentanyl and midazolam than the conventional group (P<0.05).No signifi-cant difference was found in the incidence of adverse drug reactions between the two groups (P>0.05),but the TCM group had a significantly lower incidence of delirium compared to the conventional group (P<0.05).Conclusion Angong Ni-uhuang Pill combined with fentanyl and midazolam can promote analgesia and sedation quality in critically ill patients on mechanical ventilation,reduce the consumption of fentanyl and midazolam,and lower the incidence of post-sedation delirium,with promise for clinical application.