A comparative study to evaluate efficacy of IV infusion of dexmedetomidine versus IV infusion of propofol for post-operative ICU sedation
Keywords:
dexmedetomidine, intensive care unit sedation, propofolAbstract
Aim: The purpose of the present study is to evaluate the efficacy of dexmedetomidine and propofol as an IV infusion for post-operative ICU sedation. Methodology: This study was performed on Dr. Moopen's Medical College, Wayanad, Kerala. India and duration was from January 2022 to September 2022. Thirty patients who were ambulatory and who required the post-operative mechanical ventilation or post-operative sedation were enrolled, in which 15 patients received Dexmedetomidine and remaining 15 patients received propofol. All these patients were treated for the period of 8 to 24 h. Data were analyzed using Student’s t-test and Chi-square test. The value of P < 0.05 was considered as statistically significant. Results: Demographic data were comparable. Pulse rate, respiratory rate and blood pressure were comparable. Depth of sedation and extubation time were similar. To maintain analgesia throughout the study period, patients receiving propofol infusions required significantly more analgesics than patients receiving Dexmedetomidine. Conclusion: Dexmedetomidine appears to be a safe and acceptable ICU sedative agent when both the clinician’s and patient’s perspectives are considered.
Downloads
References
Belleville JP, Ward DS, Bloor BC, Maze M. Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. Anesthesiology 1992; 77:1125-33.
Brook AD, Ahrens TS, Schaiff R, Prentice D, Sherman G, Shannon W, Kollef MH. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999;27:2609-15.
Coursin DB, Coursin DB, Maccioli GA. Dexmedetomidine. Curr Opin Crit Care 2001;7:221-6.
Fernandez-Zamora MD, Gordillo-Brenes A, Banderas-Bravo E, et al. Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery. Respir Care. 2018;63(5):550–7.
Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg 2000;90:699-705.
Holcomb BW, Wheeler AP, Ely EW. New ways to reduce unnecessary variation and improve outcomes in the intensive care unit. Curr Opin Crit Care 2001;7:304-11.
Huang S, Zhang J, Zhang X, et al. Can Dexmedetomidine improve arterial oxygenation and intrapulmonary shunt during one-lung ventilation in adults undergoing thoracic surgery? A meta-analysis of randomized, placebo-controlled trials. Chin Med J. 2017;130:1707–14.
Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002;30:119-41.
LaPar DJ, Gillen JR, Crosby IK, et al. Predictors of operative mortality in cardiac surgical patients with prolonged intensive care unit duration. J Am Coll Surg. 2013;216(6):1116–23.
Lee SH, Kim N, Lee CY, et al. Efects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: a randomised double-blinded trial. Eur J Anaesthesiol. 2016;33:275–82.
Patrick MR, Blair IJ, Feneck RO, Sebel PS. A comparison of the haemodynamic effects of propofol (‘Diprivan’) and thiopentone in patients with coronary artery disease. Postgrad Med J 1985;61 Suppl 3:23 7.
Peng K, Ji FH, Liu HY, et al. Efects of Perioperative Dexmedetomidine on Postoperative Mortality and Morbidity: A Systematic Review and Metaanalysis. Clin Ther. 2019;41(1):138–54. e4.
Peng K, Li D, Applegate RL 2nd, et al. Efect of Dexmedetomidine on Cardiac Surgery-Associated Acute Kidney Injury: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. 2020;34(3):603–13.
Rahman WR, Rhodes A, Grounds RM. The Role of Dexmedetomidine in Intensive Care. In: Vincent JL, editor. Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2009. Berlin, Heidelberg: Springer; 2009.
Rhoney DH, Murry KR. National survey of the use of sedating drugs, neuromuscular blocking agents, and reversal agents in the intensive care unit. J Intensive Care Med 2003;18:139-45.
Rhoney DH, Murry KR. National survey on the use of sedatives and neuromuscular blocking agents in the pediatric intensive care unit. Pediatr Crit Care Med 2002;3:129-33.
Scheinin H, Aantaa R, Anttila M, Hakola P, Helminen A, Karhuvaara S. Reversal of the sedative and sympatholytic effects of dexmedetomidine with a specific alpha2-adrenoceptor antagonist atipamezole: A pharmacodynamic and kinetic study in healthy volunteers. Anesthesiology 1998;89:574-84.
Schweickert WD, Gehlbach BK, Pohlman AS, Hall JB, Kress JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med 2004;32:1272-76.
Venn RM, Grounds RM. Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: Patient and clinician perceptions. Br J Anaesth 2001;87:684-90.
Venn RM, Hell J, Grounds RM. Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care. Crit Care 2000; 4:302-08.
Wang K, Wu MG, Xu J, et al. Efects of dexmedetomidine on perioperative stress, infammation, and immune function: systematic review and meta-analysis. Br J Anaesth. 2019;123:777–94.
Woods JC, Mion LC, Connor JT, Viray F, Jahan L, Huber C, et al. Severe agitation among ventilated medical intensive care unit patients: Frequency, characteristics and outcomes. Intensive Care Med 2004;30:1066-72.
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
