Comparison between dexmedetomidine and midazolam for sedation of eclampsia patients in the intensive care unit

Purpose: This study compares the effectiveness of midazolam and dexmedetomidine for the sedation of eclampsia patients admitted to our intensive care unit (ICU). Patients and Methods: Forty women with eclampsia requiring termination of pregnancy by caesarean delivery were randomized in to 2 groups of 20 to receive either midazolam or dexmedetomidine. The midazolam group received a loading dose of 0.05 mg/kg followed by an infusion of 0.1 mg kg(-1) h(-1). The dexmedetomidine group loading dose was 1 mu g/kg per-20 minutes, followed by continuous infusion at 0.7 mu g kg(-1) h(-1). Heart rate, blood pressure, Ramsey sedation score, anti hypertensive need, convulsion fits, and duration in ICU were monitored and recorded all through the ICU stay. Results: Dexmedetomidine markedly reduced heart rates for the first 24 hours (P<.05) compared with midazolam, but there were no differences at 48 and 72 hours. Mean arterial blood pressures were similar in the 2 groups (P>.05), although in the dexmedetomidine group, it was lower at 5, 6, 12, and 24 hours compared with the first 4 hours (P<.05). Moreover, fewer patients given dexmedetomidine required nitroglycerine and nitroprusside (P<.05). The duration of ICU stay was less in the dexmedetomidine group, 45.5 hours (range, 15-118 hours), than in the midazolam group, 83 hours (minimum-maximum, 15-312 hours). Conclusion: Dexmedetomidine sedation in eclampsia patients is effective in reducing the demand for anti hypertensive medicine and duration of ICU stay. (C) 2009 Elsevier Inc. All rights reserved.