A COMPARATIVE EVALUATION OF DEXMEDETOMIDINE, PROPOFOL AND MIDAZOLAM FOR INTRAOPERATIVE SEDATION IN REGIONAL ANAESTHESIA

• Published in: Journal of evolution of medical and dental sciences Vol. 6; no. 75; p. 5387
• Main Authors: Mantan, Kiwi, Pareek, Anita, Jain, Rashmi, Meena, Anju, Soni, Pramila, Sharma, Aditi
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 18.09.2017
• Subjects: Analysis; Comparative analysis; Dexmedetomidine; Dosage and administration; Midazolam; Propofol; Treatment outcome; India
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2017/1168

BACKGROUND Sedation has been shown to increase patient's satisfaction during regional anaesthesia and may be considered as a mean to increase the patient's acceptance of regional anaesthetic techniques. The aim of the study is to compare dexmedetomidine, propofol and midazolam for intra- and post-operative sedation, haemodynamics and complications. MATERIALS AND METHODS The study was conducted on 80 patients in the Department of Anaesthesiology, Sardar Patel Medical College after taking permission from Institution Research Board. Both male and female patients ranging between the age group of 20--60 years belonging to ASA grades I and II, scheduled for elective lower limb or lower abdominal surgical procedure under regional anaesthesia were included. The patients were divided into 4 groups of 20 patients in each group and received intravenous infusion midazolam (Group I), propofol (Group II), dexmedetomidine (Group III) and normal saline (Group IV) as sedation. RESULTS Mean pulse rate reduced in all the four groups up to 90 mins following spinal anaesthesia. No clinical significance was seen at 90 mins, when intergroup comparison was made. The mean systolic and diastolic blood pressure in all the four groups were up to 90 mins. Intergroup comparison was significant (p < 0.001). The onset of sedation was earliest in group II and prolonged in group III as compared to group I. Intergroup comparison is highly significant (p < 0.001). Maximum mean postoperative analgesia was in group III followed by group I and II and IV respectively. Intergroup comparison shows highly significant difference in all groups (p < 0.001). Time taken to reach sedation score 5 was highest in group III followed by group I and II. Intergroup comparison was highly significant. CONCLUSION The onset of sedation was earlier in patient who received IV propofol infusion under spinal anaesthesia as compared to patients who receive IV infusion of midazolam or dexmedetomidine or normal saline. Postoperative analgesia was maximum in patients who receive IV dexmedetomidine infusion as compared to others. KEYWORDS Dexmedetomidine, Propofol, Midazolam, Infusion, Intravenous Sedation.