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

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.