Year : 2020 | Volume
: 7 | Issue : 2 | Page : 182--187
Sedation of mechanically ventilated patients in intensive care units: Dexemedetomidine versus ketofol
Ghada F Amer
Department of Anesthesia and Surgical Intensive Care, Mansoura University, Mansoura, Egypt
Background Patients in the ICUs are usually provided with sedation and analgesia to avoid pain and anxiety, facilitate invasive maneuvers, decrease stress and oxygen utilization, and facilitate mechanical ventilation. The Association of Critical Care Medicine recommends the use of nonbenzodiazepine drugs such as propofol and dexmedetomidine in sedating the intensive care patients to improve outcomes. Usual sedation protocols should be changed by incorporating propofol, dexmedetomidine, or drug combinations to reach arousal targets and decreasing benzodiazepine use.
Objectives The study was conducted to compare between the sedative effect of dexmedetomidine versus ketamine–propofol combination (ketofol) in ICU patients on mechanical ventilation.
Patients and methods A total of 90 patients who needed sedation for postoperative mechanical ventilation and monitoring in ICUs were randomly allocated into two groups: ketofol group, where sedation of the patients was done with ketofol at a loading dose of 500 μg/kg of ketamine and propofol mixture 1 : 1 (ketamine 8 mg/ml and propofol 8 mg/ml), followed by continuous infusion at 8–10 μg/kg/min, and dexmedetomidine group, where patients were sedated with an initial bolus dose of dexmedetomidine of 2 µg/kg intravenous infused over 10 min followed by infusion rate of 0.3–0.5 µg/kg/h. Patients’ hemodynamics, Ramsay sedation scale, and total analgesic requirement were recorded.
Results Mean blood pressure and heart rate were statistically significantly lower in dexmedetomidine group than in ketofol group. Ramsay sedation score was clinically efficient in both groups but statistically higher in dexmedetomidine group than ketofol group. Dexmedetomidine group showed faster recovery time and less analgesic requirement than ketofol group.
Conclusion Dexmedetomidine is an effective sedative drug for ICU patients, with more hemodynamic stability, less analgesic requirement, and rapid recovery time than ketofol.
MD Ghada F Amer
Department of Anesthesia and Surgical Intensive Care, Mansoura Faculty of Medicine, Mansoura University, 3 Elgomhoriya Street, Mansoura City, Dakahlia, 35516
|How to cite this article:|
Amer GF. Sedation of mechanically ventilated patients in intensive care units: Dexemedetomidine versus ketofol.Res Opin Anesth Intensive Care 2020;7:182-187
|How to cite this URL:|
Amer GF. Sedation of mechanically ventilated patients in intensive care units: Dexemedetomidine versus ketofol. Res Opin Anesth Intensive Care [serial online] 2020 [cited 2020 Oct 23 ];7:182-187
Available from: http://www.roaic.eg.net/article.asp?issn=2356-9115;year=2020;volume=7;issue=2;spage=182;epage=187;aulast=Amer;type=0