Conscious sedation during diagnostic cerebral angiography: A comparative study between dexmedetomidine and midazolam

Abstract

Objective To compare the efficacy and safety of dexmedetomidine versus midazolam in conscious sedation during diagnostic cerebral angiography. Patients and methods This prospective randomized, double-blind, comparative study was conducted on 66 patients scheduled for diagnostic cerebral angiography, who were randomly allocated into two equal groups: group I (dexmedetomidine group), in which patients received infusion of dexmedetomidine 1 mcg/kg administered over 10 min followed by continuous infusion of 0.2-0.7 mcg/kg/h; and group II (midazolam group), in which patients received midazolam 0.05-0.15 mg/kg administered over 10 min followed by infusion of 0.02-0.1 mg/kg/h. Intraoperative sedation levels were titrated to achieve a bispectral index score between 70-80 and Ramsay sedation score between 3-4. Hemodynamic variables (heart rate, mean arterial pressure) and ventilation (respiratory rate, peripheral oxygen saturation) were recorded at 15 min before drugs were administered, 5 min after the infusion of the bolus dose, and then every 10 min until 1 h after the end of the procedure. The onset of sedation and the recovery time were also recorded. Results Group I showed significant decrease in heart rate, but this decrease did not require treatment. No other significant differences between groups were found with regard to main blood pressure, ventilation parameters, and the onset of sedation. Group I showed significant decrease in recovery time in comparison with group II. Conclusion Dexmedetomidine is a good alternative to midazolam for intravenous sedation during diagnostic cerebral angiography, because it seems to be reliable and safe, providing a satisfactory sedation level without any serious side effects.