DOI: 10.36347/sjams.2021.v09i01.029

Pages: 149-155

Background: To reduce anxiety and pain, increase tolerance and improve outcomes of mechanically ventilated patients, sedation and analgesia are common practice. Over decades, γ-Aminobutyric acid (GABA) receptor agonist and opioids are used commonly for sedation and analgesia, respectively in intensive care unit (ICU). Preliminary evidence indicates that the α-2 agonist dexmedetomidine may have distinct advantages to maintain both sedation and analgesia with minimal cardiovascular instability or respiratory depression, facilitate weaning from mechanical ventilation and decreases the duration of ICU stay. Aim of the study: The aim of this study was to assess the effectiveness of dexmedetomidine to the combined use of midazolam and fentanyl for sedation and analgesia in mechanically ventilated patients. Methods: This observational comparative study was conducted in the ICU of Dhaka Medical College Hospital (DMCH) at the Department of Anaesthesia, Analgesia & Intensive Care Medicine during the period from March 2017 to June 2019. Total 146 mechanically ventilated patients were included in the study according to the selection criteria. Richmond agitation-sedation scale (RASS) and the Critical-care pain observation tool (CPOT) were used for assessment of sedation and analgesia respectively in this study. At first, the patients were divided into two groups and denoted as group A, and group B. In total 79 patients receiving Dexmedetomidine were denoted as in group A, and 67 patients receiving midazolam and fentanyl as combined were included into group B. Samples were randomization by fix card lottery method. All collected data were registered, documented and analyzed in the statistical program Statistical Package for Social Science (SPSS) version 22.0. Result: Among total 146 patients, the mean age of group A and group B were 45.56±13.35 & 46.76±13.4 (years), respectively. Both groups were similar in terms of age and gender distribution (p>0.05). Dexmedetomidine was found