Effect of intracutaneous pyonex on analgesia and sedation in critically ill patients with mechanical ventilation.

Yuanyuan Wang,Peibei Duan,Jiling Wang,Qianwen Wang,Wenhua Wu,Yongqing Hang,Jia Sun,Jie Zhang

doi:10.1139/cjpp-2021-0298

Abstract

The purpose of this study was to evaluate the effect of intracutaneous pyonex on analgesia and sedation in critically ill patients who underwent mechanical ventilation. A total of 88 critically ill patients were divided into a control group and an intervention group. Critical Care Pain Observation Tool (CPOT) and Richmond Agitation and Sedation Scale (RASS) were used to evaluate pain and agitation. The dosage and treatment period of sedative and analgesic drugs in the intervention group were notably lower than the control group (p< 0.05). Analgesia compliance time in the intervention group was superior to control group (p< 0.05). The shallow sedation compliance rate in the intervention group was significantly higher than the control group (p< 0.01). There was significant difference in blood gas analysis before and after treatment between the two groups (p< 0.05). After 2h of sedation and analgesia, heart rate in the intervention group was lower than control group, but respiratory rate was higher than the control group (p< 0.05). The traditional analgesia and sedation combined with intracutaneous pyonex reduced the total amount and treatment period of sedative and analgesic drugs in critically ill patients throughout the treatment process, and it also decreased the adverse reactions such as blood pressure drops and respiratory depression.

Highlights

As a life support system, mechanical ventilation is widely used in critically ill patients (Jordan et al, 2016)
There was no marked difference in term of the dosage of administration of Propofol between the two groups, while the treatment period of Propofol in intervention group was significantly shorter than control group (p
The dosage and treatment period of administration of Remifentanil were both notably decreased in intervention group than those in control group (p

Summary

Introduction

As a life support system, mechanical ventilation is widely used in critically ill patients (Jordan et al, 2016). In order to alleviate the pain and anxiety and prevent man-machine confrontation during mechanical ventilation, analgesia and sedation procedures are very important (Singleton et al, 2015). Analgesia and sedation are mainly induced by drugs (Cunningham and Vogel, 2019). Drug-induced analgesia and sedation may cause several complications, including hypotension, respiratory insufficiency, and bradycardia A large number of studies have been carried out worldwide to reduce drug doses and maintain a satisfactory level of analgesia and sedation (Vincent et al, 2016; Ferguson et al, 2016; Nasr and DiNardo, 2016). The indwelling intracutaneous pyonex is remained in the skin for a certain period, so that the skin is stimulated by tender, continuous and stable stimulation to accomplish the treatment (Na et al, 2018)

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