Publication:

Dexmedetomidine versus propofol as a sedative agent in the intensive care unit: a randomized single blinded prospective study

Background Sedation is an essential prerequisite for every ICU patient. It promotes patient comfort, helps in alleviation of anxiety, stabilizes vitals and reduces the time to extubation and ICU discharge. This study aims at comparing dexmedetomidine versus propofol in ICU sedation with respect to maintenance of vitals, time to extubation, incidence of adverse effects and cost effectiveness.

Methods 60 intubated and mechanically ventilated post-surgical ICU patients were randomly allocated to two groups of 30 each. Group D received dexmedetomidine infusion as a loading dose of 0.1mcg/kg/min IV over 10 minutes followed by maintenance infusion of 0.2-0.7mcg/kg/h IV. Group P received propofol infusion as a loading dose of 5mcg/kg/min IV over 5 minutes followed by a maintenance infusion of 0.3-3mg/kg/h IV. Patients in both groups were maintained at Richmond agitation sedation score of -1 to -2. Measurements of HR, NIBP, SpO2 were taken at regular intervals till cessation of sedation and extubation. Data thus collected was subjected to statistical analysis.

Results Dexmedetomidine was seen to be comparable to propofol as far as maintaining vitals was concerned. Group D (dexmedetomidine) had a statistically significant shorter mean duration to sedation cessation and extubation than group P (propofol). Dexmedetomidine also had the added advantages of minimal respiratory depression, decreased opioid requirements as well as greater cost effectiveness.

Conclusions Dexmedetomidine was found to be a better choice for sedation in the ICU compared to propofol.