2018, Vol. 1, Issue 2, Part A

Methodology: 60 patients randomized into 3 groups of 20 to receive either dexmedetomidine, propofol or midazolam drug. The dexmedetomidine group loading dose was 0.5 to 1 μg/kg over 10 minutes, followed by maintenance infusion at 0.1 to 1 μg/kg/hr. The propofol group received a loading dose of 0.5 to 1 mg/kg followed by an infusion of 25 to 75 mcg/kg/min. The midazolam group received an infusion of 0.012 to 0.024 mg/kg/hr. Respiratory rate, heart rate, blood pressure, Ramsay sedation score, tramadol need, saturation, time to extubation, duration in ICU were monitored and recorded all through the ICU stay.

Results: Hypotension occurred in 6.4% patients in dexmedetomidine group, 14.22% in propofol group and 5% in midazolam group. Bradycardia occurred in 7.5% patients receiving dexmedetomidine at the time of loading of drug. During sedation mean pulse rate in dexmedetomidine group was 77.54±9.34, in propofol group 89.34±10.1 and for midazolam group 90.23±10.7. Time to tracheal extubation was less for dexmedetomidine group (7.4±1.85 hrs) and for propofol (5.6±1.56 hrs) compared to midazolam (16.9±15.62 hrs).

Conclusion: Dexmedetomidine is a satisfactory agent for sedation in ICU. Dexmedetomidine provides hemodynamic stability and have no clinically important adverse effects on respiration. The mean time from cessation of sedation to tracheal extubation was shorter for dexmedetomidine and propofol treated patients than from midazolam treated patients.