医学
镇静
异丙酚
麻醉
随机对照试验
重症监护室
不利影响
病危
外科
重症监护医学
内科学
作者
Yun Tang,Xianhui Gao,Jiqian Xu,Lehao Ren,Hong Qi,Ruiting Li,Huaqing Shu,Xiaojing Zou,Shiying Yuan,Xiaobo Yang,You Shang
出处
期刊:Critical Care
[Springer Nature]
日期:2023-12-04
卷期号:27 (1)
被引量:1
标识
DOI:10.1186/s13054-023-04760-8
摘要
Abstract Objective To compare the efficacy and safety of remimazolam besylate and propofol for deep sedation in critically ill patients. Methods In this single-center, prospective, randomized, controlled pilot study, patients in the intensive care unit (ICU) requiring deep sedation were randomized to receive remimazolam besylate or propofol intravenously. Deep sedation was defined as a Richmond Agitation and Sedation Scale (RASS) score of − 4 or − 5. Sedation depth was monitored using RASS and Narcotrend Index (NI). The primary outcome was the percentage of time within the target sedation range without rescue sedation. The secondary outcomes included ventilator-free hours within 7 days, successful extubation, length of ICU stay, and 28-day mortality. Adverse events during the interventional period were also recorded. Results Thirty patients were assigned to each group. The median (IQR) RASS score was − 5.0 (− 5.0, − 4.0), and the median (IQR) NI value was 29.0 (21.0, 37.0) during the intervention period. Target RASS was reached a median of 100% of the sedation time in the two groups. No significant differences were observed in ventilator-free hours within 7 days, successful extubation, length of ICU stay, or 28-day mortality among groups. Hypotension occurred in 16 (53.3%) patients of remimazolam group and 18 (60.0%) patients of propofol group ( p > 0.05). No patient experienced bradycardia. Conclusions Remimazolam besylate appears to be an effective and safe agent for short-term deep sedation in critically ill patients. Our findings warrant large sample-sized randomized clinical trials.
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