A comparative study of dexmedetomidine propofol and midazolam with respect to changes in mean arterial pressure and SpO2 after sedation at tertiary health care centre

Abstract

Background: Sedation is an important component of compassionate care in ICU patients to promote rest and sleep. The sedatives used most often include propofol and midazolam. These medications provide adequate sedation but also can cause oversedation. The α2 agonist dexmedetomidine have unique sedative properties that it produces only mild cognitive impairment, allowing easy communication between health-care provider and patient in the ICU. We therefore compared the sedative and analgesic properties, cardiovascular responses, ventilation and extubation characteristics, and patient perceptions of dexmedetomidine with those of the commonly used i.v. sedative agent propofol in the ICU. Material and Methods: Present study was a randomized. open label trial conducted in the ICU ppatients >18 years of age, who required immediate sedation as to permit the initiation and tolerance of mechanical ventilation. 30 patients each were randomly allocated to dexmedetomidine, propofol & midazolam group. Results: Male predominance was noted, in all groups (dexmedetomidine, propofol & midazolam), M:F ratio was 1.3 : 1. According to age distribution most common age group in dexmedetomidine, propofol & midazolam group was 31-45 years (40 %). At all times the difference in systolic blood pressure, diastolic blood pressure, SpO2, mean arterial blood pressure among all the three groups calculated by ANOVA test was not statistically significant (P>0.05). The mean time (hours) from cessation of sedation to extubation for dexmedetomidine is 7.4 hours, for propofol is 5.6 hours and for midazolam is 16.9 hours. P-value of dexmedetomidine, propofol and midazolam group is <0.001, which is statistically significant. Conclusion: Dexmedetomidine provides hemodynamic stability and have no clinically important adverse effects on respiration in terms of mean SpO2. Tracheal extubation was earlier in patients receiving dexmedetomidine and propofol than from midazolam.