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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Dexmedetomidine and Midazolam for sedation of eclamptic patients on mechanical ventilation in ICU
Dr. Sachreet Kaur, Dr. Jatinder Malhotra

Background: Eclampsia is a serious complication of pregnancy characterized by the onset of seizures or convulsions in a woman with preeclampsia. The present study was conducted to assess efficacy of Dexmedetomidine and Midazolam for sedation of eclamptic patients on mechanical ventilation in ICU. Materials & Methods: 70 eclamptic pregnant women > 18 years of age undergoing lower segment caesarean section for termination of pregnancy under general anaesthesia and requiring postoperative mechanical ventilation in ICUwere divided into 2 groups. Group I received loading dose of 0.05 mg/kg of midazolam over 10 minutes and group II received loading dose of 1 μg/kg of dexmedetomidine over 10 minutes. Vital parameters -Invasive blood pressure (IBP), oxygen saturation (SpO2), heart rate (HR) and electrocardiography (ECG) of all patients were monitored in the ICU. The Ramsay Sedation Score was assessed hourly. Side effects were compared. Results: The mean Ramsay sedation score pre- drug was 1.2 in group I and 1.4 in group II and post- operatively was 2.5 in group I and 2.9 in group II. The difference was significant (P< 0.05). Pre- drug and post- operatively, pulse rate (beats/min) was119.2 and 120.5 and 84.5 and 78.4 in group I and II respectively. The pre- drug mean SBP (mm Hg) was 152.4 and 148.6 and post- operatively was 124.2 and 110.2. The pre- drug mean DBP (mm Hg) was 94.2 and 82.4 and post- operativelywas 82.0 and 70.4. The pre- drug mean MAP (mm Hg) was 114.2 and 100.6 and post- operativelywas 100.4 and 88.2 respectively. The difference was significant (P< 0.05).Bradycardia was observed in 5 in group I and 11 in group II and hypotension 2 in group I and 6 in group II.The difference was significant (P< 0.05). Conclusion: Dexmedetomidine was as effective as midazolam for producing and maintaining adequate short-term sedation of mechanically ventilated eclampsia patients.

 
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