Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: patient and clinician perceptions (original) (raw)
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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...
IOSR Journals , 2019
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.
Experienced Use of Dexmedetomidine in the Intensive Care Unit: A Report of a Structured Consensus
Turkish journal of anaesthesiology and reanimation, 2018
Management of pain, agitation and delirium (PAD) remains to be a true challenge in critically ill patients. The pharmacological proprieties of dexmedetomidine (DEX) make it an ideal candidate drug for light and cooperative sedation, but many practical questions remain unanswered. This structured consensus from 17 intensivists well experienced on PAD management and DEX use provides indications for the appropriate use of DEX in clinical practice. A modified RAND/UCLA appropriateness method was used. In four predefined patient populations, the clinical scenarios do not properly cope by the current recommended pharmacological strategies (except DEX), and the possible advantages of DEX use were identified and voted for agreement, after reviewing literature data. Three scenarios in medical patients, five scenarios in patients with acute respiratory failure undergoing non-invasive ventilation, three scenarios in patients with cardiac surgery in the early postoperative period and three scen...