TO COMPARE THE SEDATION AND ANALGESIA PRODUCED BY CONTINUOUS INFUSIONS OF DEXMEDITOMIDINE AND BUTORPHANOL IN CRITICALLY ILL PATIENTS ON MECHANICAL VENTILATION: A RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL.

Dr. Neha Panse

Volume : VII, Issue : XII, December - 2017

TO COMPARE THE SEDATION AND ANALGESIA PRODUCED BY CONTINUOUS INFUSIONS OF DEXMEDITOMIDINE AND BUTORPHANOL IN CRITICALLY ILL PATIENTS ON MECHANICAL VENTILATION: A RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL.

Dr. Neha Panse

Abstract :

BACKGROUND: Sedation in intensive care unit for critically ill patients on mechanical ventilation is a complex clinical problem and the current therapeutic approaches have potential side effects. This study was aimed at compå inj. dexmedetomidine with inj. butorphanol as sedative and analgesic, their untoward effects, whether their use reduces the requirement of rescue sedative and analgesic agents and their cost effectiveness .

METHODS: 60 Patients of both sexes in the age group of 20–60 yrs requiring mechanical ventilation for postoperative (major laparotomy surgeries) indications were included in the study. Once the patient was put on mechanical ventilation, the infusion of specified drug was started using syringe pump. Dexmedetomidine was started at the rate of 0.7 µgm/kg/ hr and butorphanol was started at the rate of 5 µgm /kg/hr depending upon the parameters of assessment and requirement of the patient. Infusion was continued for 24hrs or until weaning off from the ventilator which ever was less. Vital parameters, Glasgow Coma Score, Sedation score (Brussels’s Sedation score), agitation during weaning and after extubation and nausea vomiting were compared.

RESULTS: The patients receiving dexmedetomidine infusion were haemodynamically more stable and were easily arousable while he patients receiving butorphanol infusion were more drowsy with acceptable, but lower respiratory rates.

CONCLUSION: Dexmedetomidine is a suitable alternative to the commonly used sedatives in ICU, but its high cost may limit its use in the initial phase.