PURPOSE: This study compares the effectiveness of midazolam and dexmedetomidine for the sedation of eclampsia patients admitted to our intensive care unit (ICU). PATIENTS AND METHODS: Forty women with eclampsia requiring termination of pregnancy by caesarean delivery were randomized in to 2 groups of 20 to receive either midazolam or dexmedetomidine. The midazolam group received a loading dose of 0.05 mg/kg followed by an infusion of 0.1 mg kg(-1) h(-1). The dexmedetomidine group loading dose was 1 microg/kg per 20 minutes, followed by continuous infusion at 0.7 microg kg(-1) h(-1). Heart rate, blood pressure, Ramsey sedation score, antihypertensive need, convulsion fits, and duration in ICU were monitored and recorded all through the ICU stay. RESULTS:Dexmedetomidine markedly reduced heart rates for the first 24 hours (P < .05) compared with midazolam, but there were no differences at 48 and 72 hours. Mean arterial blood pressures were similar in the 2 groups (P > .05), although in the dexmedetomidine group, it was lower at 5, 6, 12, and 24 hours compared with the first 4 hours (P < .05). Moreover, fewer patients given dexmedetomidine required nitroglycerine and nitroprusside (P < .05). The duration of ICU stay was less in the dexmedetomidine group, 45.5 hours (range, 15-118 hours), than in the midazolam group, 83 hours (minimum-maximum, 15-312 hours). CONCLUSION:Dexmedetomidine sedation in eclampsia patients is effective in reducing the demand for antihypertensive medicine and duration of ICU stay.
RCT Entities:
PURPOSE: This study compares the effectiveness of midazolam and dexmedetomidine for the sedation of eclampsiapatients admitted to our intensive care unit (ICU). PATIENTS AND METHODS: Forty women with eclampsia requiring termination of pregnancy by caesarean delivery were randomized in to 2 groups of 20 to receive either midazolam or dexmedetomidine. The midazolam group received a loading dose of 0.05 mg/kg followed by an infusion of 0.1 mg kg(-1) h(-1). The dexmedetomidine group loading dose was 1 microg/kg per 20 minutes, followed by continuous infusion at 0.7 microg kg(-1) h(-1). Heart rate, blood pressure, Ramsey sedation score, antihypertensive need, convulsion fits, and duration in ICU were monitored and recorded all through the ICU stay. RESULTS:Dexmedetomidine markedly reduced heart rates for the first 24 hours (P < .05) compared with midazolam, but there were no differences at 48 and 72 hours. Mean arterial blood pressures were similar in the 2 groups (P > .05), although in the dexmedetomidine group, it was lower at 5, 6, 12, and 24 hours compared with the first 4 hours (P < .05). Moreover, fewer patients given dexmedetomidine required nitroglycerine and nitroprusside (P < .05). The duration of ICU stay was less in the dexmedetomidine group, 45.5 hours (range, 15-118 hours), than in the midazolam group, 83 hours (minimum-maximum, 15-312 hours). CONCLUSION:Dexmedetomidine sedation in eclampsiapatients is effective in reducing the demand for antihypertensive medicine and duration of ICU stay.
Authors: Fayez Alshamsi; Kallirroi Laiya Carayannopoulos; Anders Granholm; Joshua Piticaru; Kimberley Lewis; Zainab Al Duhailib; Dipayan Chaudhuri; Laura Spatafora; Yuhong Yuan; John Centofanti; Jessica Spence; Bram Rochwerg; Dan Perri; Dale M Needham; Anne Holbrook; John W Devlin; Osamu Nishida; Kimia Honarmand; Begüm Ergan; Eugenia Khorochkov; Pratik Pandharipande; Mohammed Alshahrani; Tim Karachi; Mark Soth; Yahya Shehabi; Morten Hylander Møller; Waleed Alhazzani Journal: Intensive Care Med Date: 2022-06-01 Impact factor: 41.787