Abstract：Objective: To analyze the application value of midazolam CLTCI with BIS feedback control in ICU sedation. Methods: 120 patients admitted in ICU of Suizhou Affiliated Hospital to Hubei Medicine University from January 2015 to December 2016 selected as the research objects, were randomly divided into group A of 40 cases using micro pump continuous infusion, group B of 40 patients with target controlled infusion, (target controlled, infusion, TCI) group C of 40 cases using the closed-loop target controlled infusion (CLTCI) and APACHE were performed within 24h after admission II score. The data of HR, RR, MAP before sedation, BIS and sedation effect were recorded and compared. Results: Compared with the basic values of MAP and HR, the MAP of three groups decreased obviously after sedation, but there was no statistical significance (P > 0.05); The BIS values corresponding to the different Ramsay scores were negatively correlated in the three groups (correlation coefficient, r=-0.856). With the depth of sedation, BIS values of patients in three groups were significantly decreased. Among them, the BIS value corresponding to 3 points, 4 points, 5 points and 6 branches was significantly lower than the corresponding BIS value of the 1 branche. The corresponding BIS values of 4 points and 6 branches were significantly lower than the corresponding BIS values of the 2 branches, all of which were statistically significant (P < 0.05). The corresponding values of the 5 branches were statistically significant (P < 0); There was significant difference between the three groups in maintaining ideal sedation time, 60~80 range, BIS value, time percentage and average dosage of midazolam in 24h, and statistically significant (P < 0.05); Group C maintain ideal sedation time and the percentage reached 60 ~ 80 BIS value of the percentage of time was significantly higher than that of group A, group B, group C 24h, the average amount of midazolam significantly less than group A and group B were statistically significant (P < 0.05). Conclusions: Compared with the continuous infusion and TCI infusion, the CLTCI can effectively reduce the dosage of midazolam while maintaining sedation, and it is worthy of clinical application.
[1] Alireza E,Mehrnaz M,Nasser K,et al.Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures[J].Dental Research Journal,2016,19(7):1~6. [2] 唐燕.脑电双频指数监测在老年胃肠肿瘤根治性手术全身麻醉中的应用评价[J].现代中西医结合杂志,2016,9(14):1572~1574. [3] Pekel M,Postaci NA, et al.Sevoflurane versus propofol for electroconvulsive therapy: effects on seizure parameters, anesthesia recovery, and the bispectral index[J].Turkish Journal of Medical Sciences,2016,13(2):756~763. [4] Renu J,Vinayak P,Mohan C,et al.Epidural ropivacaine with dexmedetomidine reduces propofol requirement based on bispectral index in patients undergoing lower extremity and abdominal surgeries[J].Anesthesia:Essays and Researches,2016,8(5):45~49. [5] 张胜荣.脑电双频指数及颅底静脉氧饱和度对急性脑损伤患者相关性及预后研究[J].临床医学,2016,14(12):12~13. [6] 曲彦亮,周赞宫,王世端,等.脑电双频指数监测在小儿臂丛神经阻滞复合二异丙酚全身麻醉中的应用[J].医学研究生学报,2013,14(4):377~380. [7] Neena J,Pooja M,Shoyeb K,et al.Effect of bispectral index versus end-tidal anesthetic gas concentration-guided protocol on time to tracheal extubation for halothane-based general anesthesia[J].Anesthesia:Essays and Researches,2016,16(8):591~596. [8] 李丽,夏晖,陈华永.脑电双频指数监测下右美托咪定的镇静效应对麻醉诱导中丙泊酚靶控输注的用量影响及血流动力学变化[J].山西医药杂志,2016,16(11):1302~1305. [9] 陈胜阳,王研心,王更富,等.脑电双频指数在心脏手术体外循环麻醉深度监测中的应用效果观察[J].实用医院临床杂志,2017,4(1):49~51. [10] 苏龙,常文利.脑电双频指数监测在脑出血术后患者镇静中的应用[J].中国实用神经疾病杂志,2015,21(11):131~132. [11] 侯海军,柯敬东,刘英,等.脑电双频指数监测与靶控输注丙泊酚联合小剂量舒芬太尼在无痛胃肠镜检查麻醉中的应用[J].临床和实验医学杂志,2015,14(8):683~685. [12] 安卫平,徐炳欣,高晓华,等.脑电双频指数监测地佐辛联合依托咪酯在老年无痛胃镜检查中的应用[J].河南医学研究,2016,17(6):6~8. [13] 汪萍,任三姐,陈界石,等.脑电双频指数监测下右美托咪啶复合咪达唑仑在喉罩置入中应用的可行性研究[J].安徽医药,2015,21(8):1598~1599. [14] 刘颖,刘汉,薛艳,等.脑电双频指数在ICU机械通气患者镇静中的监测价值[J].内科急危重症杂志,2012,18(1):33~35. [15] 刘宇,孙桂锋,王纪良,等.脑电双频指数监测在CCU患者镇静治疗中的应用[J].山东医药,2013,23(48):54~55
2017, Vol. 23 
冀公网安备13080202000786号