Application effect of bispectral index combined with Richmond agitationsedation score in the sedation evaluation of patients with mechanical ventilation
XIONG Yu1 WANG Jin1 PENG Meina2 PENG Binfei1 LI Jianzhi1 LIU Juan1 WAN Xinwen1
1.Department of Intensive Care Unit, Nanchang First Hospital, Jiangxi Province, Nanchang 330008, China;
2. Department of Transitional Ward, Jiangxi Cancer Hospital, Jiangxi Province, Nanchang 330000, China
Abstract:Objective To investigate the application effect of bispectral index (BIS) combined with Richmond agitationsedation scale (RASS) in the sedation evaluation of patients with mechanical ventilation. Methods A total of 60 patients with mechanical ventilation in the Emergency Intensive Care Unit (EICU) of Nanchang First Hospital from December 2019 to June 2020 were divided into control group (n=30) and experimental group (n=30) by the random number table method. The control group was treated only with routine sedation therapy, and the experimental group was treated with BIS combined with RASS score to guide sedation therapy. The treatment time of EICU, the total use of sedatives, the time of mechanical ventilation, the adverse reactions during the diagnosis and treatment of EICU and the total hospital stay were compared between the two groups. Results The duration of EICU stay and mechanical ventilation in experimental group was shorter than that in control group, and the total incidence of adverse events was lower than that in control group, with statistical significances (P<0.05). There was no significant difference in total hospital stay between the two groups (P>0.05). The total amount of Midazolam in experimental group was less than that in control group, the difference was statistically significant (P<0.05). There was no significant difference in the total amount of dexmedetomidine between the two groups (P>0.05). Conclusion Sedation therapy guided by RASS score combined with BIS can significantly shorten the time of mechanical ventilation, the time of EICU treatment, reduce the dose of sedatives and the total incidence of adverse events, which is worthy of clinical promotion.
熊玉; 王瑾;彭美娜;彭滨菲;李剑智; 刘娟; 万辛闻. 脑电双频指数联合躁动-镇静评分在机械通气患者镇静评价中的应用效果[J]. 中国当代医药, 2022, 29(13): 32-35转43.
XIONG Yu1 WANG Jin1 PENG Meina2 PENG Binfei1 LI Jianzhi1 LIU Juan1 WAN Xinwen1. Application effect of bispectral index combined with Richmond agitationsedation score in the sedation evaluation of patients with mechanical ventilation. 中国当代医药, 2022, 29(13): 32-35转43.
Pearson SD,Patel BK.Evolving targets for sedation during mechanical ventilation[J].Curr Opin Crit Care,2020,26(1):47-52.
[1]
Barr J,Egan TD,Sandoval NF,et al.Propofol dosing regimens for ICU sedation based upon an integrated pharmacokinetic-pharmacodynamic model[J].Anesthesiology,2001,95(2):324-333.
[3]
Taffarel P,Bonetto G,Jorro B F,et al.Sedation and analgesia in patients on mechanical ventilation in pediatric intensive care units in Argentina[J].Arch Argent Pediatr,2018,116(2):e196-e203.
[4]
Kydonaki K,Hanley J,Huby G,et al.Challenges and barriers to optimising sedation in intensive care:a qualitative study in eight Scottish intensive care units[J].BMJ Open,2019,9(5):e24549.
Legros V,Mourvillier B,Floch T,et al.Use of BRASS in sedated critically-ill patients as a predictable mortality factor:BRASS-ICU[J].Neurol Res,2021,43(4):283-290.
[11]
Connor CW.A Forensic Disassembly of the BIS Monitor[J].Anesth Analg,2020,131(6):1923-1933.
[12]
Pérez-García S,Lozano-Carrascal N,Ruiz-Roca JA,et al.Evaluation of endovenous sedation using BIS monitoring in dentistry.A systematic review[J].Med Oral Patol Oral Cir Bucal,2020,25(4):e439-e448.
[13]
Lee KJ,Kim BJ,Han MK,et al.Effect of Heart Rate on Stroke Recurrence and Mortality in Acute Ischemic Stroke With Atrial Fibrillation[J].Stroke,2020,51(1):162-169.
[14]
Foisy H,Pioche M,Chabrun E,et al.Role of Rapid Drink Challenge During Esophageal High-resolution Manometry in Predicting Outcome of Peroral Endoscopic Myotomy in Patients With Achalasia[J].J Neurogastroenterol Motil,2020,26(2):204-214.
[15]
Messina AG,Wang M,Ward MJ,et al.Anaesthetic interventions for prevention of awareness during surgery[J].Cochrane Database Syst Rev,2016,10(10):D7272.
[16]
Xu N,Chen Q,Huang ST,et al.Sufentanil Reduces Emergence Delirium in Children Undergoing Transthoracic Device Closure of VSD After Sevoflurane-Based Cardiac Anesthesia[J].Braz J Cardiovasc Surg,2020,35(5):660-665.
[17]
Hui D,De La Rosa A,Wilson A,et al.Neuroleptic strategies for terminal agitation in patients with cancer and delirium at an acute palliative care unit:a single-centre,double -blind,parallel -group,randomised trial [J].Lancet Oncol,2020,21(7):989-998.
[18]
Fuller BM,Roberts BW,Mohr NM,et al.A study protocol for a multicentre,prospective,before-and-after trial evaluating the feasibility of implementing targeted SEDation after initiation of mechanical ventilation in the emergency department(The ED-SED Pilot Trial)[J].BMJ Open,2020,10(12):e41987.
[19]
Weeden M,Desai N,Sriram S,et al.A pilot study of high frequency accelerometry-based sedation and agitation monitoring in critically ill patients[J].Crit Care Resusc,2020,22(3):245-252.