- 期刊
The Use of Diazepam, Midazolam and Propofol for Sedation in the Surgical Intensive-Care Unit
外科加護病房中比較Diazepam, Midazolam和Propofl之鎮靜效果
摘要
選擇三十位住進外科加護病房，疾病嚴重程度相同（APACHEII分數小於20），且使用呼吸器的病患做為研究。將他們隨意分為三組，分別於24小時內使用Diazepam，Midazolam和Propofol做為鎮靜劑，並使用Morphine止痛。Diazepam組24小時平均使用56.4±0.3mg，Midazolam組和Propofol組分別以0.08±0.01mg/kg/hr和1.4±0.5mg/kg/hr連續淮流以達到滿意之鎮靜程度。結果顯示Midazolam和Propofol比diazepam有較佳之鎮靜滿意度和意識快速恢復的特性，而Diazepam組意識恢復，尤其用在肝功能異常之病人。在維持不變的心輸出量下，血壓三組皆有明顯下降。Midazolam組並能明顯改善血氧濃度。總體而官，Mldazolam或Propofol之連續灌流可視為加護病房中既安全又有效的鎮靜方式。
並列摘要
Thirty critically ill patients (acute physiological and chronic health evaluation II score ＜20) in the surgical ICU were randomly allocated to 3 groups respectively to receive diazepam, midazolam or propofol sedation to facilitate mechanical ventilation over a 24-hour period. Analgesia was provided by intravenous morphine. To maintain adequate sedation, the mean total dose of diazepam given in intermittent boluses was 56.4±0.3 mg/24hr. The mean continuous infusion rates of midazolam and propofol were 0.08±0.01 mg/kg/hr and 1.4±0.5 mg/kg/hr respectively. In terms of reversibility of sedation, midazolam and propofol outscored diazepam. Recovery tended to be prolonged in patients with liver disease in all three groups, especially in the diazepam group. Systolic and diastolic blood pressures fell 30 minutes after drug administration in all groups (p＜0.05). Patients sedated with midazolam showed significant increase in oxygenation (p＜0.05). We conclude that either midazolam or propofol infusion can provide effective and safe sedation for ventilated patients in ICU.