The Use of Propofol after Midazolam for Long-Term Sedation in Postoperative Mechanically Ventilated Patients

Objective To determine whether the use of propofol after midazolam could be more reliable compared with midazolam or propofol alone for longterm sedation Patients Mechanically Ventilated.Methods 72 patients were randomly divided into 3 groups,which are group midazolam(M),group propofol after midazolam(M-P) and group propofol(P).All patients received anesthesia with fentanvl 2.0μg/(kg·h) propofol 6mg/(kg·h) tracium 0.5mg/(kg·h).After admission to the ICU,All patients received analgesia with fentanvl at a fixed dose of 0.4μg/(kg·h) continuously and received additional bolus doses (8μg/kg) during potentially painful procedures.M idazolam was used for the maintenance of Ⅳ sedation.The initial dose was 0.04 mg/(kg·h),and this was adjusted to get satisfactory result sedation 4 or 5 on the Ramsay sedation scale-every 4 h.In group M and M-P.In Group M-P,midazolam was switched to propofol approximately 24 h before the expected stopping of sedation.the initial dose of propofol was 1 mg/(kg·h) and was adjusted by the same procedure as midazolam.The bolus dose of propofol was 1 mg/kg,Group P,propofol [0.3～5mg/(kg·h)] was always used for the maintenance of Ⅳ sedation.Results The serum concentration of triglyceride in Group P after extubation.The recovery time was obviously shorter in Group P,compared with that in Group M,Group M-P.But there was no significant difference in the time stayed in ICU in three Groups.The agitation mumber after extubation was significantly more in Group M,compared with in Group,Group M-P.The agitation mumber after extubation in Group P was obviously more than that in GroupM-P.Conclusion The use of propofol after midazolam could be more reliable compared with propofol alone for longterm sedation Patients Mechanically Ventilated.