2018, Vol. 1, Issue 2, Part A
Comparison between dexmedetomidine and propofol for short-term sedation of postoperative mechanically ventilated patients
Author(s): Dr. Kavitha G
Abstract: Background and Objectives: Post-operative patients requiring mechanical ventilation in surgical ICUs frequently require adequate sedation and analgesia to modulate physiological responses to stress and pain, reducing morbidity and mortality in the ICU. Inadequate sedation and analgesia can have serious consequences, including self-removal of important intraluminal tubes and vascular catheters, aggressive behaviour by patients toward care providers, and poor patient–ventilator synchrony. Sedation can lead to a longer duration of mechanical ventilation, as well as longer ICU and hospital stays. Dexmedetomidine is a highly selective and potent 2 adrenergic agonist with anxiolytic, anaesthetic, hypnotic, and analgesic properties. It is approved for use as a sedative agent in post-operative intensive care units. We compared the efficacy and safety profile of Dexmedetomidine to that of the most commonly used sedative, Propofol, as a short-term sedative in post-operative patients in ICUs. Methodology: 100 patients over the age of 18 who had major abdominal or pelvic surgeries requiring at least 6 hours of artificial ventilation and were admitted to intensive care units were included as subjects, and they were randomly divided into two groups of fifty each. Group D received Dexmedetomidine at a loading dose of 2.5g/kg and a maintenance dose of 0.5g/kg/hr, while Group P received Propofol at a loading dose of 1mg/kg and a maintenance dose of 0.5mg/kg/hr. The level of sedation using the Ramsay sedation score, hemodynamic variables, safety profile, and fentanyl requirement to achieve adequate analgesia. Results: The Ramsay sedation score was within the desired range (2-4) in both the Dexmedetomidine and Propofol groups (p>0.05). Patients who received Dexmedetomidine infusion had significantly lower heart rates than patients who received Propofol infusion (p0.00). There were no significant differences in SBP, DBP, MAP, or oxygen saturation between the two groups. The total Fentanyl dose requirement was significantly higher in the Propofol group (66.310.1g) than in the Dexmedetomidine group (31.09.5 g; p=0.001). Conclusion: Dexmedetomidine and Propofol are both safe sedatives for post-operative mechanically ventilated patients. Patients in the Dexmedetomidine group were easily aroused to cooperate with no signs of irritation and less Fentanyl analgesia.
Pages: 69-75 | Views: 544 | Downloads: 254
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How to cite this article:
Dr. Kavitha G. Comparison between dexmedetomidine and propofol for short-term sedation of postoperative mechanically ventilated patients. Int J Med Anesthesiology 2018;1(2):69-75. DOI: 10.33545/26643766.2018.v1.i2a.307