Comparison of Dexmedetomidine and Midazolam for sedation in Mechanically ventilated patients in Neurology ICU setup

Abstract

Introduction: The main interest of the current article was to determine and investigate the effects of Dexmedetomidine in comparison to Midazolam required for sedation of the patients on Mechanical ventilation in Neurology ICU as sedative agents using RASS (Richmond Agitation sedation scale) to assess sedation level. The time required for the extubation of the patients after stopping two sedatives was compared between the two groups. Material and methods: This was a randomized, prospective, and comparative study conducted on the patients of ASA classes II and III who were on mechanical ventilators requiring sedation in Neurology ICU from the period October 2021 to April 2022 at the Department of Anaesthesia, Jawaharlal Nehru Medical College, Acharya Vinoba Bhave rural hospital (AVBRH), Sawangi, Meghe. All the patients were more than 18 years and less than 70 years old. Results: The time to achieve the target sedation range was statistically significant. In group A, the patient's time taken was 10.36 minutes as compared to 7.43 minutes in group B. The difference between the two groups concerning the time required for extubation was statistically significant. The time needed for extubating the patient after stopping Midazolam was more than the Dexmedetomidine group. Conclusion: In comparing two sedative drugs, it was found that Dexmedetomidine as a sedative resulted in early weaning from the mechanical ventilator compared to Midazolam in ICU Patients. However, Dexmedetomidine was found to have more occurrences of hypotension and bradycardia as compared to Midazolam.