ObjectiveTo explore the effect of goal directed analgesia on patients with noninvasive positive pressure ventilation (NPPV) in the intensive care unit (ICU).MethodsThis was a retrospective study. Two hundred sixty-four patients requiring non-invasive positive pressure ventilation were enrolled in the ICU of this hospital, including 118 patients in the empirical analgesia group and 146 in the goal directed analgesia group. The empirical analgesia group was treated with remifentanil to analgesia and propofol, midazolam or dexmedetomidine to sedation. The sedative depth maintained <1 measured by the score of the Richmond restless sedative scale (RASS). The same analgesic and sedative drug were first used in the goal directed analgesia group to maintain the Critical Care Pain Observation Tool score <2, and the RASS score <1 was maintained after the analgesia depth were achieved. Whether the patients occurred delirium was assessed by the Confusion Assessment Method for the ICU. The dosage of analgesic and sedative drugs, the dependability (based on the total ventilation time in the first 24 hours after ventilation), the incidence of delirium, the rate of invasive ventilation, the total time of NPPV and the length of stay of ICU were observed in the two groups.ResultsThere were no significant differences in age, sex, APACHEⅡ score, mean arterial pressure, heart rate, respiratory rate, SpO2, arterial blood gas and the reason of NPPV between the two groups. The dosage of analgesic and sedative drugs in the goal directed analgesia group were less than the empirical analgesia group, and the dependability was higher than that of the empirical analgesia group ［(12.6±5.8)h vs. (10.9±4.8)h, P<0.05), and the incidence of delirium and the rate of invasive ventilation were also lower than those of the empirical analgesia group (15.8% vs. 25.4%, P<0.05; 32.9% vs. 44.9%, P<0.05). The total time of NPPV in the goal directed analgesia group was shorter than that of the empirical analgesia group ［(28.6±8.8)h vs. (37.3±10.7)h, P<0.05), but there was no significant difference in the length of stay in ICU.ConclusionGoal directed analgesia can improve the dependability of NPPV patients, reduce the use of sedative drugs, and decrease the incidence of delirium and rate of invasive ventilation.