Study of clinical application of dexmedetomidine on patients in the period just before mechanical ventilation withdrawed

Objective To investigate sedative effect and security of dexmedetomidine on patients in the period just before mechanical ventilation withdrawed.Methods 80 cases with mechanical ventilation in ICU were divided into 2 groups randomly.In the peroid of 4 hours just before mechanical ventilation was withdrawed all the patients in group 1 were sedated with dexmedetomidine till endotracheal intubation was withdrawed and all the patients in group 2 were sedated with midazolam.Sedation level was asssessed using the ramsay scale,and heart rate(HR),mean arterial pressure(MAP)、breath frequency(R) and pulse oxygen saturation(SaO2) were recorded at different time points : before the drug using,10min,1h,3h after using,while extubation,and 10min after withdrawed.Results Stable sedative effect was gained in all 44 patients in group 1,and Ramsay scores were showed between 3～4.No respiratory depression was found and endotracheal intubation was withdrawed on time.No significant change was found in breath frequency and pulse oxygen saturation between before and after endotracheal intubation withdrawal.Stable sedative effect was gained in all 36 patients in group 2,and Ramsay scores were showed between 3～5.Blood pressure and heart rate showed a little decreasing after using Midazolam.When Midazolam was stoped using before 1 hour of extubation,Ramsay scores were decreased to 1～2 in 34 patients.Blood pressure and heart rate showed significantly increasing when endotracheal intubation was withdrawed in all patients.Extubation was delayed because of not fully awake in 2 patients.Conclusion An effective sedation level can be achieved by using Dexmedetomidine in mechanically ventilated patients and extubation reaction was depressed effectively and safely.Respiraton and hemodynamic could be stablely maitained before and after extubation by using Dexmedetomidine.