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Comparison of Midazolam and Propofol for Entropy - Guided Sedation During Regional Anesthesia

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Background and Aims: This study aimed to compare the sedation using Entropy of Midazolam and Propofol in regional anesthesia in terms of Onset, Recovery and Side Effects. Introduction: Regional anesthesia is a safe and popular anesthetic technique. Effective sedation is essential for regional anesthetic technique too, to allay anxiety in the patients and improve their comfort, co-operation. Use of entropy will reduce over sedation of the patient and better monitoring of the hypnotic state of the patient. Methods: 100 ASA I/II adult patients undergoing elective surgery under regional anesthesia for lower abdominal and lower limb surgeries were enrolled in the study and randomly allocated into two groups. Group M: Midazolam 0.1% IV infusion started with 0.5 mg/kg/hr, Group P: Propofol 1% IV infusion started with 6 mg/kg/hr till entropy value reaches 60 then titrated to maintain entropy of 50 to 60 through syringe pump and was continued till the last suture was completed. Results: Dose required to reach the level of sedation was 0.5 mg/kg/hr vs 6mg/kg/hr and to maintain sedation was 0.17±0.04 mg/kg/hr vs 1.23±0.25 mg/kg/hr and onset of sedation was 4.17± 0.42 vs 2.81±0.44 minutes where as time for recovery from sedation was 9.57±2.67 vs 6.76±0.83 minutes in GroupM vs Group P respectively. Hemodynamic changes were significantly higher in Group P than Group M. Conclusion: Both Midazolam and Propofol can be used for sedation under regional anesthesia. Onset of action and recovery is faster with Propofol and Midazolam is more cardio stable.

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Background and Aims: This study aimed to compare the sedation using Entropy of Midazolam and Propofol in regional anesthesia in terms of Onset, Recovery and Side Effects. Introduction: Regional anesthesia is a safe and popular anesthetic technique. Effective sedation is essential for regional anesthetic technique too, to allay anxiety in the patients and improve their comfort, co-operation. Use of entropy will reduce over sedation of the patient and better monitoring of the hypnotic state of the patient. Methods: 100 ASA I/II adult patients undergoing elective surgery under regional anesthesia for lower abdominal and lower limb surgeries were enrolled in the study and randomly allocated into two groups. Group M: Midazolam 0.1% IV infusion started with 0.5 mg/kg/hr, Group P: Propofol 1% IV infusion started with 6 mg/kg/hr till entropy value reaches 60 then titrated to maintain entropy of 50 to 60 through syringe pump and was continued till the last suture was completed. Results: Dose required to reach the level of sedation was 0.5 mg/kg/hr vs 6mg/kg/hr and to maintain sedation was 0.17±0.04 mg/kg/hr vs 1.23±0.25 mg/kg/hr and onset of sedation was 4.17± 0.42 vs 2.81±0.44 minutes where as time for recovery from sedation was 9.57±2.67 vs 6.76±0.83 minutes in GroupM vs Group P respectively. Hemodynamic changes were significantly higher in Group P than Group M. Conclusion: Both Midazolam and Propofol can be used for sedation under regional anesthesia. Onset of action and recovery is faster with Propofol and Midazolam is more cardio stable.

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This page is a summary of: Comparison of Midazolam and Propofol for Entropy - Guided Sedation During Regional Anesthesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6119.41.
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