A STUDY OF EFFICACY OF DEXMEDETOMIDINE AND MIDAZOLAM FOR SEDATION OF ECLAMPTIC PATIENTS ON MECHANICAL VENTILATION IN ICU.

Corresponding Author:
Dr. Santosh Kumar Sharma,
Type 4/3, BRD Medical College Campus,
Gorakhpur-273013.
E-mail: santoshtata76@gmail.com

ABSTRACT

BACKGROUND

It remains a challenge to provide optimal sedation for eclamptic patients on mechanical ventilation in ICU, who are often irritable. Traditionally, Midazolam, a fast-acting benzodiazepine, has been the most commonly administered sedative drug for ICU patients worldwide. Dexmedetomidine, a highly selective α_2-adrenergic receptor agonist, is a newer sedative used for ICU sedation having better haemodynamic stability and no respiratory depressant effect.

Aim- To compare efficacy of dexmedetomidine and midazolam for sedation of eclamptic patients on mechanical ventilation in ICU.

MATERIALS AND METHODS

In a prospective study, 100 eclamptic patients aged more than 18 years who required mechanical ventilation in intensive care unit (ICU) after lower segment caesarean section (LSCS) were divided equally into two groups to receive either midazolam (Group I) or dexmedetomidine (Group II). Vital parameters, level of sedation (Ramsay sedation Score 1-6), any side effects were observed and compared.

RESULTS

Both groups showed decrease in heart rate (HR) and blood pressure (SBP, DBP, MAP) at all-time intervals, but the decrease was statistically significant (p <0.005) in Group II at most time intervals. Both the groups maintained predominantly stable haemodynamics at all times. The Ramsay Sedation Score was also comparable and it maintained at a mean score of 2-3 at most time intervals in both groups. The incidence of bradycardia and hypotension was significantly higher in group II as compared to group I.

CONCLUSION

Dexmedetomidine provided an effective alternative to midazolam in producing and maintaining controlled (RSS 2-3) short-term sedation in mechanically ventilated eclampsia patients and stable haemodynamics.

KEYWORDS

ICU Sedation, Dexmedetomidine, Midazolam, Eclampsia.