Dexmedetomidine Versus Midazolam: Does Choice of Sedatives Effect the Duration of Mechanical Ventilation

Abstract

Objective: To evaluate Dexmedetomidine and Midazolam in mechanical ventilation regarding the extubation time.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Kharian, from May to Dec 2019.

Methodology: A total of 88 patients on mechanical ventilator support in ICU were included. In Group-D (Dexmedetomidine), a loading dose of 1 μg/kg Dexmedetomidine over ten minutes was given, and sedation was maintained by continuous infusion at the rate of 0.2–0.6 μg/kg/hr. In Group-M (Midazolam), an intravenous 0.5–1 mg bolus of Midazolam was given over two minutes and maintained by continuous infusion at 10-50 μg /kg/hr; doses were increased incrementally 1–2 mg/hour until desired sedation level was achieved. The Richmond Agitation and Sedation Score assessed the sedation level. The total duration of mechanical ventilation and time from weaning off trial to extubation was recorded.

Results: In this study, the mean duration of mechanical ventilation was 63.07±32.07 hours in Group-D versus 86.14±38.96 hours in Group-M (p-value=0.003). The mean extubation time was 25.09±7.33 hours in Group-D versus 30.31±8.37 hours in Group-M (p-value =0.002).

Conclusion: This study concluded that Dexmedetomidine is superior Midazolam in providing sedation to mechanically  ventilated patients. It reduces the duration of mechanical ventilation and time of extubation.
Keywords: Dexmedetomidine, Extubation, Mechanical ventilation, Midazolam, Sedation.