Comparison of the Effect of Intravenous Dexmedetomidine and Midazolam on Hemodynamic and Respiratory Mechanic in Patients under Mechanical Ventilation in the Intensive care unit of Bandar Abbas Shahid Mohammadi Hospital, 2020

It remains a challenge to provide optimal sedation for patients on mechanical ventilation in ICU. Traditionally, Midazolam has been the most commonly administered sedative drug for ICU patients worldwide. Dexmedetomidine is a newer sedative used for ICU sedation having better hemodynamic stability and no respiratory depressant effect.

This was a parallel randomized, double-blind study. Study population was intensive care unit patients undergoing mechanical ventilation. All the 33 patients received 1 μg/kg IV dexmedetomidine over 10 minutes followed by a maintenance infusion of 0.5 μg/kg/h dexmedetomidine. After 24 hours patients received 0.05 mg/kg midazolam followed by a maintenance infusion of 0.1 mg/kg/h. The dosage of sedative was changed according to the outcome of maintaining a target sedation level of RASS 0 to -1. The cardiovascular and ABG parameters and quality of ventilation were measured at baseline, 12 and 24 hours after sedation.

28 patients (84.8%) were men and 5 (15.2) were women. The mean age of the patients was 36.12±69.74 years. Systolic blood pressure (P<0.005), diastolic blood pressure (P=0.003), mean arterial pressure (P=0.02) and heart rate (P=0.003) were significantly higher in Midazolam group at 24 hours. In addition, O2 saturation was significantly different between dexmedetomidine and midazolam at 12 hours (P=0.03) and 24 hours (P=0.001). ABG parameters were similar between two sedatives.

The results of this study showed that dexmedetomidine has better hemodynamic effects than midazolam. Also, the effects of dexmedetomidine and Midazolam on lung mechanics are the same.