A better drug for extubation-dexmedetomidine or fentanyl

Abstract

Background: Patients on Mechanical ventilator support in intensive care unit (ICU) require analgesia and sedation to facilitate synchronized mechanical ventilation. Our aim of study is to compare the efficacy of dexmedetomidine with Fentanyl to facilitate smooth and shorter time of extubation from mechanical ventilation. The study highlights the characteristics of cardiovascular responses, ventilation, extubation and safety profile of both the drugs. Methods: A prospective randomized double-blind study was done on total of 40 adults mechanically ventilated patients of either sex, aged 18-60 years were selected. Randomized in two groups of 20 patients each received intravenous infusion of dexmedetomidine (0.2-0.7 mcg/kg/h) or fentanyl infusion (1-2 mcg/kg/h) as needed to maintain Ramsay sedation scale ranging 2-4. Extubation following standard extubation protocol was done. Time for extubation and vital parameters were recorded. Results: The extubation time in the dexmedetomidine group was significantly lesser than in the fentanyl group. Cardiovascular response was stable in dexmedetomidine group than the Fentanyl group. Conclusions: Dexmedetomidine facilitates shorter time to extubation, more hemodynamic stability, easy arousability, and lack of respiratory depression.