The effects of the levels of serum beta-endorphin and substance P on mechanical ventilated patients with midazolam combined with fentanyl / 中国医师进修杂志

ABSTRACT

Objective To evaluate the effects ofbeta-endorphin (β-EP) and substance P (SP)with sedative and analgesic drugs on mechanical ventilated patients. Methods Twenty-eight mechanical ventilated patients were randomly divided into two groups midazolam group (M group, 14 cases) and midazolam combined with fentanyl group (M + F group, 14 cases). Eight healthy persons were as control group (C group). The sedative target was VAS≤3 scores and Ramsay 2-4 scores. The levels of serum β -EP and SP were tested before sedation and 12, 24 h after sedation in mechanical ventilated patients and at 8 Am in C group. The sedation levels were evaluated and the hemodynamie and respiratory parameters were recorded before sedation and 1, 12, 24 h after sedation in mechanical ventilated patients. The oxygenation index was measured before sedation and 1,12, 24 h after sedation. Results The levels of serum β -EP and SP in M and M+F group were significantly higher than those in C group(P< 0.05). After sedation, the level of SP in M+F group [(101.42 ± 12.46) ng/L]was significantly lower than that in M group [(132.72 ± 23.82) ng/L] (P < 0.05). Compared with before sedation, there were significant differences in heart rate, VAS and Ramsay scores between M group and M+F group (P< 0.05). Compared with M group, pressure airway and respiratory rate at 12, 24 h and total after sedation were lower in M+F group (P <0.05). The amount of serum SP in mechanical ventilated patients. Fentanyl improves the ventilator synehron and reduces the dose of midazolam.