Title: Comparative Study of Propofol and Midazolam Infusion for Sedation in ICU Patients
Authors: Raja Avinash, Akhileshwar
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.64
Abstract
Background: In the modern practice of anaesthesia and intensive care, the intensivist are very concerned about the stressful environment in which patients often experience anxiety, pain and inability to sleep. Sedation for the patients in the ICU is used primarily to increase patient comfort through the provision of anxiolysis, analgesia and sedation to minimize resistance to mechanical ventilation.
Material & Methods: The study was carried out in patients admitted in the Intensive Care Unit of IGIMS, PATNA. After approval from ethical committee Forty adult patients, between ASA I to III, who were intubated and expected to be mechanically ventilated for a period of approximately twenty four hours were included in the study
Results: We compared the quality of sedation using Ramsay sedation score. At the start of the study 8 patients in propofol group and 6 patient in midazolam group were agitated (RSS = 1). By one hour from start of sedation the numbers had decreased to only 1 patient in propofol group whereas 3 patients in midazolam group were still agitated. Eighteen patients in the propofol group had a baseline Ramsay score of less than optimal (RSS = 3), compared to 16 patients in midazolam group. By end of 1 hr from start of infusion, 9 patients in propofol group had achieved the sedation score of 3 in contrast to only 5 patients in midazolam group.
Conclusion: The conclusions of our study is Both propofol and midazolam were effective in providing adequate level of sedation. However propofol provided significantly higher occasions of optimal sedation compared to midazolam. Weaning from mechanical ventilation was significantly better in propofol.
References
1 Comparison of propofol and midazolam for sedation in critically ill patients. Aitkenhead AR1, Pepperman ML, Willatts SM, Coates PD, Park GR, Bodenham AR, Collins CH, Smith MB, Ledingham IM, Wallace PG.
2. Comparison of propofol and midazolam for sedation in intensive care unit patients. Ronan KP1, Gallagher TJ, George B, Hamby B.
- Prolonged sedation of critically ill patients with midazolam or propofol: impact on weaning and costs. Barrientos-Vega R, Mar Sánchez-Soria M, Morales-García C, Robas-Gómez A, Cuena-Boy R, Ayensa-Rincon A.Crit Care Med. 1997 Jan; 25(1):33-40.
- Comparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial. Chamorro C1, de Latorre FJ, Montero A, Sánchez-Izquierdo JA, Jareño A, Moreno JA, Gonzalez E, Barrios M, Carpintero JL, Martín-Santos F, Otero B,Ginestal R.
- Synergistic sedation with propofol and midazolam in intensive care patients after coronary artery bypass grafting. Carrasco G, Cabré L, Sobrepere G, Costa J, Molina R, Cruspinera A, Lacasa C.
- Continuous infusions of lorazepam, midazolam, and propofol for sedation of the critically ill surgery trauma patient: a prospective, randomized comparison. McCollam JS, O'Neil MG, Norcross ED, Byrne TK, Reeves ST. Crit Care Med. 1999 Nov;27(11):2454-8.