Comparison Of Midazolam Propofol And Dexmedetomidine For Sedation And Antihypertensive Requirement Inpost Operative Electively Ventilated Eclamptic Patients In The Intensive Care Unit

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N. Yadav, and M. A. A. Z. Manish Jha, “Comparison Of Midazolam Propofol And Dexmedetomidine For Sedation And Antihypertensive Requirement Inpost Operative Electively Ventilated Eclamptic Patients In The Intensive Care Unit”, ijmhs, vol. 5, no. 2, pp. 46–49, Apr. 2015.
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Abstract

ntroduction- Eclampsia a complication of severe preeclamsia is characterized by new onset of seizures which is not attributable to any other cause in a pregnant female whose fetus has crossed age of viability i.e. 20 wks.

Objective- To compare the effectiveness of midazolam, propofol and dexmedetomidine for the sedation of eclampsia patients admitted to our intensive care unit (ICU).

Material and Methods – A study of 60 eclamptic patients was taken up who required mechanical ventilation in ICU and were randomly divided into three groups. All patients received MgSO4 2 g/h for 24 hours. GrM group received 0.05mg/kg loading dose followed by infusion of 0.1mg/kg/hr. GrP received propofol  loading dose 1mg/kg followed by infusion of 3mg/kg/hr and GrD group received dexmedetomidine at 1mcg/kg  over 20 mins followed by infusion 0.7mcg/kg/hr. patients were maintained on Ramsay sedation score of 2-3 and their mean arterial pressure was maintained between 90-130mmhg . If it exceeded the range NTG and SNP were added. Standard criteria were followed for weaning from ventilator.

Results - Dexmedetomidine produced better hemodynamic stability in eclamptic patients. There was significant reduction in requirement of additional analgesics (p< 0.035) and antihypertensives (p<0.004). Duration of ICU stay was less in eclampsia patients (p<0.0029) who required dexmedetomedine. We believe that the better results of patient in GrD group was because of ability of dexmedetomidine to denervate sympathetic nervous system.

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