Comparison of Sedation and Analgesia Produced By Dexmedetomidine and Butorphanol in Critically Ill Patients on Mechanical Ventilation: A Prospective Observational Study (original) (raw)

2019, IOSR Journals

BACKGROUND: Sedation in the intensive care unit for critically ill patients on mechanical ventilation is a complex clinical problem, and the current therapeutic approaches have potential side effects. This study aimed at comparing inj. Dexmedetomidine with inj.Butorphanol as sedative and analgesia. METHODS: 60 Patients of both sexes in the age group of 18-60 yrs requiring mechanical ventilation are included in the study. Once the patient on mechanical ventilation, the infusion of the specified drug was started using a syringe pump. Dexmedetomidine started at the rate of 1mcg/kg/hr loading dose over 15 minutes followed by 0.25 mcg/kg/hr, and Butorphanol was started at the rate of 5mcg/kg/hr depending upon the parameters of assessment and requirement of the patient. The infusion continued for 24hrs. Vital parameters, Ramsay Sedation score, Behavioural pain score were compared. RESULTS: The patients receiving Dexmedetomidine infusion were hemodynamically more stable and were easily arousable when compared to patients receiving Butorphanol infusion CONCLUSION: Dexmedetomidine is a suitable alternative to the commonly used sedatives in ICU, but its high cost may limit its use in the initial phase.

Adjunctive dexmedetomidine therapy in the intensive care unit: a retrospective assessment of impact on sedative and analgesic requirements, levels of sedation and analgesia, and ventilatory and hemodynamic parameters

Pharmacotherapy, 2007

To determine if adjunctive dexmedetomidine therapy in intensive care patients alters requirements for and levels of sedation and analgesia, and to describe hemodynamic and ventilatory parameters. Retrospective, noncontrolled, descriptive study of clinical practice. Four intensive care units (ICUs; medical, surgical, neurosurgical, or burn) in a university-affiliated medical center. Forty patients who were already receiving sustained use of propofol, lorazepam, or fentanyl when dexmedetomidine was started. Medical records were identified by searching the pharmacy database for patients who had received continuous-infusion dexmedetomidine from January 2000-January 2003 while in one of the four ICUs. Primary end points were discontinuation or dosage reduction of other sedatives or fentanyl from the hour before to 6 hours after starting dexmedetomidine. Other outcomes included levels of sedation and analgesia before and after dexmedetomidine and description of ventilatory and hemodynamic...

Comparison of dexmedetomidine and midazolam infusion for sedation in patients admitted in intensive care unit

Journal of Chitwan Medical College

Introduction: Dexmedetomidine and midazolam are frequently used to maintain sedation in mechanically ventilated patient in intensive care unit. The study compared dexmedetomidine and midazolam infusion in mechanically ventilated patient in terms providing effective sedation. Methods: This was one year prospec­tive comparative study conducted in 130 mechanically ventilated patients who were randomly divided in two groups receiving either dexmedetomidine or midazolam infusion for sedation. Sedation level was assessed by Riker Sedation-Agitation Scale with the aim of maintaining target sedation score of 3 to 4. The two drugs were compared in terms of sedation level in first 24 hours, time required to achieve target sedation level, hemody­namic changes and adverse effects including ICU delirium. The outcome was measured in terms of duration of mechanical ventilation, length of ICU stays and ICU mortality. Results: Both dexmedetomidine and midazolam achieved target sedation level in a co...

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