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A Comparative Study used to Evaluate the Quality of Sedation using Dexmedetomidine and Propofol Infusion in Critically Ill Patients Admitted in ICU

Neeraj Kumar, Senior Resident, Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar 801507, India. , Amarjeet Kumar1 , Neeraj Kumar1 , Chandni Sinha2 , Niraj Kumar1 , Mamta Bara1 , Umesh Kumar Bhadani3 , Ashok Kumar4

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Indian Journal of Anesthesia and Analgesia 4(3):p 815-821, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.43

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Abstract

Introduction: The ICU environment produces high level of stress, strain and discomfort to the patients with physiochemical, physiological psychological alterations. So adequate level of analgesia and sedation to the patient is necessary for better outcome. We compared a relatively new sedative dexmedetomidine to gold standard sedative propofol with respect to sedation, analgesia, effect on hemodynamic parameters in patients admitted in ICU. Aims & Objective: 1. To compare the effectiveness of sedation with dexmedetomidine and propofol in critically ill patient in ICU. 2. To compare haemodynamic and any adverse events observed in both groups. Method: To evaluate this Forty (40) patients of ASA grade I to III, aged 18–60 yr, who were admitted in the ICU were divided into two equal groups in a randomized, double blinded fashion. Group A received I.V Dexmedetomidine 1 µg/kg in 10 mints as initial loading dose followed by 0.2-0.7 µg/kg/min. Group B received I.V. propofol 75 µg/kg/min in 10min followed by maintenance dose of 12.5µg/kg/min.The Ramsay sedation scores and hemodynamic (SBP and HR) and respiratory (RR) variables were recorded at baseline, at 10 min, at 30 min, at 1hr and 4hrly for 24 hr. Observation: Following parameter will be monitored (1) Quality of sedation using Ramsay sedation score. (2) H.R (3) R.R (4) NIBP (5) Spo2 (6) Adverse events. Conclusion: Dexmedetomidine has excellent sedation for the patient admitted in ICU as compare to Propofol. Dexmedetomidine is a safe sedative agent with patient easily aroused to co-operative without showing irritation. Patients remained hemodynamically stable with minimal depression of cardiovascular system and respiratory functions in Dexmedetomidine group when compared to Propofol group.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.43

Keywords

Dexmedetomidine; Propofol; Sedation; Mechanical Ventilation. 

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