Exmedetomidine vs Midazolam for Sedation in critically ill patients

Objective: To compare the efficacy dexmedetomidine and midazolam for sedation in critically ill patients.Methods: Sixty patients admitted to the intensive care unit(ICU) of our hospital from October 2010 to February 2011 that were in need of sedation and analgesia were randomly divided into dexmedetomidine group(n=30) and midazolam group(n=30).Patients in dexmedetomidine group were given a loading dose of dexmedetomidine(1 μg/kg) for 10 minutes and then maintained with 0.2~0.7μg·kg-1·h-1.Patients in midazolam group were given a loading dose of midazolam(0.05 mg/kg) for 1 minute and then maintained with 0.02~0.1μg·kg-1·h-1.Satisfactory about sedation level,length of mechanical ventilation,time to restore consciousness after the termination of drug use,incidence of delirium,were compared between the two groups.Results: The satisfactory about sedation level in dexmedetomidine group(83.3%) was higher than that in midazolam group(33.3%)(P0.05) when intake dose was adjusted to maintain the Ramsay score of 2-4.The patient in dexmedetomidine group could restore consciousness shortly after the termination of drug use,with an average time of(30.0±9.8) min,significant shorter than(80.0±6.7) min in midazolam group(P0.05).There was no significant difference in length of mechanical ventilation between dexmedetomidine group and midazolam group[(5.16±1.68)hours vs(5.21±1.56) hours ](P0.05).The incidence of delirium in dexmedetomidine group(54%)was evidently lower than that in midazolam group(76.6%)(P0.05).Conclusions: Comparing with midazolam,dexmedetomidine shows higher satisfactory sedation level,shorter awakening time,lower incidence of delirium.