Sedative and analgesic effects analysis of dexmedetomidine combined with remifentanil in adult patients with severe acute respiratory distress syndrome

Abstract

Objective To investigate the sedative and analgesic effects of dexmedetomidine combined with remifentanil in adult patients with severe acute respiratory distress syndrome (ARDS). Methods A total of 151 patients with severe ARDS were divided into treatment group (76 cases) and control group (75 cases). On the basic treatment of ARDS, the control group received remifentanil needle combined with midazolam needle, the treatment group was treated with remifentanil and dexmedetomidine for sedation and analgesia, the days of extubation, the incidence of ventilator-associated pneumonia, the length of stay in ICU, the 1 month and 3 month survival rate of the two groups were statistically analyzed. Results The average number of days of extubation in the treatment group was 8.9 d, which was significantly lower than that of the control group (13.1 d), the difference was significant (P<0.05); the incidence of ventilator-associated pneumonia in the treatment group was 4.1%, which was significantly lower than that (9.4%) in the control group, the difference was significant (P<0.05); the average hospitalization days of intensive care unit (ICU) in the treatment group was 14.5 d, which was significantly lower than that of the control group (18.3 d), the difference was significant (P<0.05); the 1 month survival rate of the treatment group was 49.5%, which was significantly higher than that of the control group (45.2%), the difference was significant (P<0.05); the 3 month survival rate of the treatment group was 43.7%, which was significantly higher than that of the control group (38.7%), the difference was significant (P<0.05). Conclusions The application of remifentanil combined with dexmedetomidine in sedation and analgesia can significantly alleviate the respiratory depression in patients with ARDS, keep the patient’s spontaneous breathing, reduce complications, shorten the length of stay in ICU, and significantly increase the survival rate. Key words: Adult severe acute respiratory distress syndrome; Sedation; Analgesia; Dexmedetomidine; Remifentanil