A Comparison of Dexmedetomidine and Midazolam for Sedation in Gynecologic Surgery Under Epidural Anesthesia

Abstract

Background: To evaluate the efficacy of dexmedetomidine (DEX) versus midazolam (MDZ) for sedation during gynecologic surgery under epidural anesthesia. Methods : This was a randomized, double-blinded study. The study was designed to accrue 121 patients scheduled for oophorectomy or/and hysterectomy , to test for equivalence in sedation during surgical procedures, defined as less than a 10% difference in the proportion of patients with a Ramsay Sedation Scale (RSS) score of < 3 (1 - 6 scale). Results : One hundred forty patients were enrolled, with 124 patients evaluable for outcomes: 63 received midazolam, while 61 received dexmedetomidine. Dexmedetomidine produced comparable sedation and satisfaction scores to midazolam, but it was not associated with respiratory depression. Bispectral index (BIS) values were significantly less with dexmedetomidine than midazolam at the same RSS score (P < 0.05). Compared with Group MDZ, heart rate (HR) of Group DEX was lower at each time point in the surgery, and there were no significant differences in mean artery pressure (MAP) between the two subject groups. Conclusions : Dexmedetomidine for sedation in gynecologic surgery under epidural anesthesia is safe and feasible. Compared with midazolam, it not only provides a satisfactory and arousable sedation but without respiratory depression. doi:10.4021/jcs107e