بررسی تاثیر استفاده از معیار بی قراری- خواب آلودگی رایکر بر پیامدهای بالینی بیماران تحت اعمال جراحی پیوند عروق کرونر

Aims: frequent investigation of the patient for determining sedation level is one of the main measures in care of critically ill patient especially after heart surgeries. Riker scale is a valid and reliable tool which has been used in different studies as sedation-agitation scale in patients hospitalized in Intensive Care Unit (ICU). This study had been done with the aim of “investigating the effect of Riker scale on clinical outcome of patients under coronary artery bypass graft surgery (CABG)” . Methods: this clinical trial study was done in Imam Ali Hospital of Kermanshah in ۲۰۱۲. ۱۱۶ patients, after coronary artery bypass graft surgery were selected and randomly divided into equal intervention and control groups through convenience sampling. In the intervention group, the level of patient’s sedation was monitored by Riker scale with Kappa agreement coefficient r=۰.۹۲ and in control group it was done by a method based on physiologic responses. Data were collected with researcher-made questionnaire and checklist which had face and content validity and they were analyzed with SPSS-۱۸ software and descriptive and inferential statistical tests (chi-square, independent t and fisher). Results: there was a significant reduction in drug consumption of sufentanil (as sedating drugs) (۸±۵.۵ vs. ۲۳±۱۲.۵ microgram (mcg)), duration of mechanical ventilation (۷.۱±۲.۳۷ vs. ۹.۳±۲.۶ hours) and duration of ventilation with SIMV mode (۳.۷ ± ۱.۷۸ vs. ۵.۴۵± ۲.۱۴ hours) in intervention group in compare with control group (P<; ۰/۰۰۱). There wasn’t any significant difference statistically between two groups regarding length of stay in ICU and hospital and delirium appearance. Conclusion: Findings of this study suggest use of Riker sedation- agitation scale for monitoring awakening in patients undergoing coronary artery bypass graft surgery in ICUs with the aim of decreasing duration of mechanical ventilation and sedative drugs.

Keywords:

Sedation , Riker scale , CABG , آرامش , معیار رایکر , جراحی پیوند عروق کرونر