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BACKGROUND: Coronary artery bypass graft surgery (coronary artery bypass grafting, CABG) is the most effective method of internationally recognized cardiovascular surgical treatment of coronary heart disease, more than 30 years of history. After coronary artery bypass grafting in patients with heart and lung function is poor circulation instability after surgery in order to guarantee the supply of oxygen to maintain normal gas exchange, usually reserved for endotracheal intubation and mechanical ventilation assisted breathing. Therefore, patients need sedation, analgesic prescription easy assisted mechanical ventilation and regulation of the stress response, sedation and analgesia is the basis of the comprehensive treatment of coronary artery bypass grafting in patients in intensive care wards (intensive care unit, ICU). Such patients with varying degrees of restlessness and pain, which affects the respiratory function. Sedative, analgesic quiet, patients can improve breathing and reduce the body's oxygen consumption, stable hemodynamics. Coronary artery bypass grafting in patients with a certain dose of sedative, analgesic, can improve the tolerance of mechanical ventilation, improve respiratory status, and is conducive to the recovery of cardiopulmonary function, to avoid the adverse consequences of postoperative agitation caused to accelerate the rehabilitation of patients . Right dexmedetomidine (dexmedetomidine, DxM) is a U.S. Food and Drug Administration (FDA) was approved in 1999, a new type of highly selective a2 adrenergic agonists, DxM with a dose-dependent sedation, analgesia and anxiolytic effects can be used for short-term sedation of adults within 24 h. China in July 2009 formally approved the right dexmedetomidine used clinically. In this study, the right dexmedetomidine for sedation in CABG patients after cardiac surgery ICU. Patients with sedation compared with propofol sedative effects and side-effects to provide the basis for clinical treatment. Objective: The study of CABG patients after cardiac surgical ICU right dexmedetomidine sedative effect. Methods: 60 cases of elective surgery in patients with coronary heart disease, age 50 to 70 years old, male or female, were randomly divided into 2 groups: control group (A) and right dexmedetomidine group (B), 30 cases in each group. Of group B patients in the ICU right dexmedetomidine sedation 1.0ug/kg right dexmedetomidine continuous infusion for 10 minutes, after 0.2-0.7 ug / kg / h, the A-group of patients in the ICU application propofol phenol sedation. The two groups of patients in the discontinuation of the offline and tracheal extubation standard is reached. Record of two groups of patients before treatment 0h, 1h after treatment, 2h, 3h, 4h, 5h, 6h and extubation (Eh), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP). Regained consciousness after two groups of patients, according to Steward awakening score table ratings, respectively, to record the two groups of patients rated postoperative duration of mechanical ventilation and extubation time and awake and after extubation dose of morphine in different time stages, as well as the number of cases of adverse reactions . The result: the sex ratio of the two groups of patients, age, height, weight, no significant differences (P gt; 0.05). Extubation of the two groups of patients, group A patients heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) was significantly higher than before treatment (P lt; 0.05), heart rate of patients in group B ( HR) no significant change (P gt; 0.05), and group A patient's blood pressure, heart rate was significantly higher than that of group B patients (P lt; 0.05). And waking rated group A than in group B (P lt; 0.05), duration of mechanical ventilation of the two groups of patients were 10 ± 0.6h (A group) and 7.0 ± 0.7h (B group), time to extubation were 16.6 ± 0.5h (A group) and 7.5 ± 0.5h (B group) (P lt; 0.05). Group B patients regained consciousness after extubation 6 stages morphine dose was significantly less than in group A (P lt; 0.05). The incidence of adverse reactions in patients of group B is lower than the A group. Conclusion: the right dexmedetomidine sedative effect for CABG patients after cardiac surgical ICU waking better quality, stable hemodynamic adverse reactions such as nausea, back to sleep, restlessness low incidence, with good security.
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