Comparison of midazolam and dexmedetomidine for sedation in postoperative intubated patients of head and neck surgery on spontaneous ventilation in intensive care unit Dr. Chaudhari Ashok1,*, Dr. Singam Amol2,**, Dr. Jejani Ayushma3,*** 1Professor, Department of Anaesthesiology, Jawaharlal Nehru Medical College and AVBRH Hospital, Sawangi, Meghe, Wardha 2Professor and HOD, Department of Anaesthesiology, Jawaharlal Nehru Medical College and AVBRH Hospital, Sawangi, Meghe, Wardha 3Junior Resident, Department of Anaesthesiology, Jawaharlal Nehru Medical College and AVBRH Hospital, Sawangi, Meghe, Wardha *Corresponding Author E-mail: drashokchaudhari@gmail.com
*dramolsingam@gmail.com
*jejaniayushma12@gmail.com
Online published on 25 August, 2021. Abstract Introduction Sedation is important in the care of the critically ill and postoperative patients. Amount of drug and duration for which it is given, is important in determining patient outcome. Aim Study aimed to compare the safety and efficacy of injection midazolam and injection dexmedetomidine for sedation in postoperative patients of oromaxillofacial surgery with endotracheal tube in-situ, on spontaneous ventilation in ICU. Methodology This prospective, randomized, comparative study was conducted on 60 patients undergoing oromaxillofacial surgery who were randomized in two groups of 30 patients each. Group D received injection demedetomidine loading dose of 1μg/kg over 15 minutes, followed by infusion at the rate of 0.2–0.7μg/kg/hr (microgram/kilogram/hour) and Group M received injection midazolam loading dose of 0.05mg/kg over 15 minutes followed by maintenance infusion at the rate of 0.02–0.06mg/kg/hr (milligram/kilogram/hour). The monitored indices included heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, SpO2 and Ramsay sedation score at the start of sedation when the Ramsay sedation score (RSS) was I and time to extubation after stopping sedation. Results Target sedation range was achieved in a mean duration of 10.36 ± 3.05 minutes in dexmedetomidine group and that in midazolam group was 7.43±2.06 minutes. Highest value of RSS score in dexmedetomidine group was 2.43±0.50, which was observed at the 4th and 10th hour whereas in midazolam group it was 2.83±0.38 which was observed at 6th hour of the study period. Total dose of rescue analgesic required was more in midazolam group as compared to the dexmedetomidine group. The mean duration of extubation after cessation of sedation was 33.27±11.37 minutes in dexmedetomidine group and 49.43±5.58 minutes in midazolam group. Conclusion Injection dexmedetomidine is better as compared to injection midazolam for postoperative sedation. Top Keywords Dexmedetomidine, Midazolam, Sedation, Intensive care unit, Intubated, Spontaneous ventilation, Maxillofacial surgery. Top |