What is it about?

Midazolam for Postoperative Analgesia and Sedation in Mechanically Ventilated Patients

Featured Image

Why is it important?

Context: Postoperative patients requiring mechanical ventilation in surgical ICU’s require adequate sedation and analgesia in order to modulate physiological response to stress and pain, hence reducing morbidity and mortality in the ICU. The consequences of inadequate sedation and analgesia can be sustained, including selfremoval of intraluminal tubes and vascular catheters, aggressive behavior by patients against care providers, and poor patient-ventilator synchrony. Oversedation can lead to prolonged duration of mechanical ventilation, more prolonged ICU, and hospital stays. Aims: To evaluate the effects of dexmedetomidine and midazolam for sedation in postoperative mechanically ventilated patients. Study Design: Arandomized prospective study. Methods: 100 patients aged above 18 years after major abdominal or pelvic surgeries requiring a minimum of 6 hours of artificial ventilation admitted to intensive care units were included as subjects, and they were randomly divided into two groups of fifty each. Group D received Dexmedetomidine, a loading dose of 2.5 μg/kg, and a maintenance dose of 0.5 g/kg/hr, and Group M received Midazolam a loading dose of 0.05 mg/kg and a maintenance dose of 0.025 mg/kg/hr. Both groups were compared for the level of sedation using Ramsay sedation score, hemodynamic variables, safety profile. Statistical analysis used: Chi-square test and Student’s unpaired t-test. Results: Ramsay sedation score was within the desired level (2–4) in both dexmedetomidine and midazolam group (p > 0.05). Patients who received dexmedetomidine infusion had significantly lower heart rates compared to patients who received midazolam infusion (p < 0.00), there were no significant differences in SBP, DBP, MAP and oxygen saturation between two groups. Conclusion: Dexmedetomidine and midazolam are safe sedative drugs for postoperative mechanically ventilated patients. Patients were easily aroused to cooperate without signs of irritation within the dexmedetomidine group.

Perspectives

Context: Postoperative patients requiring mechanical ventilation in surgical ICU’s require adequate sedation and analgesia in order to modulate physiological response to stress and pain, hence reducing morbidity and mortality in the ICU. The consequences of inadequate sedation and analgesia can be sustained, including selfremoval of intraluminal tubes and vascular catheters, aggressive behavior by patients against care providers, and poor patient-ventilator synchrony. Oversedation can lead to prolonged duration of mechanical ventilation, more prolonged ICU, and hospital stays. Aims: To evaluate the effects of dexmedetomidine and midazolam for sedation in postoperative mechanically ventilated patients. Study Design: Arandomized prospective study. Methods: 100 patients aged above 18 years after major abdominal or pelvic surgeries requiring a minimum of 6 hours of artificial ventilation admitted to intensive care units were included as subjects, and they were randomly divided into two groups of fifty each. Group D received Dexmedetomidine, a loading dose of 2.5 μg/kg, and a maintenance dose of 0.5 g/kg/hr, and Group M received Midazolam a loading dose of 0.05 mg/kg and a maintenance dose of 0.025 mg/kg/hr. Both groups were compared for the level of sedation using Ramsay sedation score, hemodynamic variables, safety profile. Statistical analysis used: Chi-square test and Student’s unpaired t-test. Results: Ramsay sedation score was within the desired level (2–4) in both dexmedetomidine and midazolam group (p > 0.05). Patients who received dexmedetomidine infusion had significantly lower heart rates compared to patients who received midazolam infusion (p < 0.00), there were no significant differences in SBP, DBP, MAP and oxygen saturation between two groups. Conclusion: Dexmedetomidine and midazolam are safe sedative drugs for postoperative mechanically ventilated patients. Patients were easily aroused to cooperate without signs of irritation within the dexmedetomidine group.

Red Flower Publication Publications
Red Flower Publication Pvt Ltd

Read the Original

This page is a summary of: Comparison between Dexmedetomidine and Midazolam for Postoperative Analgesia and Sedation in Mechanically Ventilated Patients, Indian Journal of Anaesthesia and Analgesia, April 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7220.16.
You can read the full text:

Read

Contributors

The following have contributed to this page