Comparison of Intensive Care Unit Sedation Using Dexmedetomidine, Propofol, and Midazolam

Introduction: This study compares the effectiveness of dexmedetomidine for the sedation of patients admitted to our intensive care unit (ICU) with propofol and midazolam in respect to tracheal extubation and length of stay in ICU and to study changes in heart rate (HR), mean arterial pressure, SpO2 during and after sedation. Materials and Methods: A total of 90 patients randomized into three groups of 30 to receive either dexmedetomidine, propofol, or midazolam drug. The dexmedetomidine group loading dose was 0.5-1 μg/kg per 10 min, followed by maintenance infusion at 0.1-1 μg/kg/h. The propofol group received a loading dose of 0.5-1 mg/kg followed by an infusion of 25-75 mcg/kg/min. The midazolam group received an infusion of 0.012-0.024 mg/kg/h. Respiratory rate, HR, blood pressure, Ramsay sedation score, tramadol need, saturation, time to extubation, duration in ICU were monitored and recorded all through the ICU stay. Results: Hypotension occurred in 6.4% patients in dexmedetomidine group, 14.22% in propofol group, and 5% in midazolam group. Bradycardia occurred in 7.5% patients receiving dexmedetomidine at the time of loading of drug. During sedation mean pulse rate in dexmedetomidine group was 77.54 ± 9.34, in propofol group 89.34 ± 10.1 and for midazolam group 90.23 ± 10.7. Reduced time to tracheal extubation for dexmedetomidine group (7.4 ± 1.85) h, for propofol (5.6 ± 1.56) h compared to midazolam (16.9 ± 15.62) h. Conclusion: Dexmedetomidine is a satisfactory agent for sedation in ICU. Dexmedetomidine provides hemodynamic stability and has no clinically important adverse effects on respiration. The mean time from cessation of sedation to tracheal extubation was shorter for dexmedetomidine and propofol treated patients than from midazolam treated patients.