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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 1, Jan-Feb 2019, Pages 287-296
 

Original Article

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

Nutan NM1, Mubina Begum Bujapur2, Nazeer Ahmed K3, Sanjeev Birajdar4

1Consultant, Dept of Anesthesia, SSNMC Super Specialty Hospital, Bengaluru, Karnataka 560098, India, 2Assistant Professor 3Professor 4Associate Professor Dept of Anesthesia, Al-Ameen Medical College, Vijayapura, Karnataka 586108, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.41

Abstract

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.


Keywords : Midazolam; Propofol; IV Sedation; BIS (Bispectral Index).
Corresponding Author : Mubina Begum Bijapur