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Abstract

Safety and Efficacy of Dexmedetomidine, Ketofol, and Propofol for Sedation of Mechanically Ventilated Patients

Introduction The Society of Critical Care Medicine recommended using non -benzodiazepine agents as propofol and dexmedetomidine for sedation of the critically ill patients in intensive care units. Aims and objectives This study aimed to evaluate the safety and efficacy of ketofol, dexmedetomidine or propofol for sedation of postoperative mechanically ventilated patients in intensive care unit. Materials and methods The study included ninety postoperative mechanically ventilated patients in the intensive care unit divided randomly into three equal groups. Group A: 30 patients received ketofol an initial bolus dose (500mcg/kg) of ketamine/propofol 1:1 (ketamine 8 mg/ml and propofol 8 mg/ml‏‏ followed by a maintenance dose of (10 mcg/kg/min). Group B: 30 patients received loading dose infusion of dexmedetomidin diluted in 0.9% sodium chloride 1mcg /kg/h over 10min followed by a maintenance infusion of 0.2-0.7mcg/kg/h. Group C: 30 patients received propofol undiluted as an infusion of 1-3mg/kg/h, after a loading dose infusion up to1mg/kg over10 min. Sedation level, bispectral index, systolic and diastolic blood pressure, heart rate, recovery time, complications (hypertension, hypotension, bradycardia). Result RAMSY sedation score was statistically significantly higher in group A than group B at the sixth and twelfth hour; it was statistically significantly higher in group A than group C from the first to the twenty-fourth hour and was statistically significantly higher in group B than group C at first, the sixth and eighteenth hour. The recovery time was longer in group A compared to group B and C, and it was statistically significant, no complications recorded in the three groups. Conclusion Using ketofol, dexmedetomidine or propofol was effective in maintaining sedation without hemodynamic complications in postoperative mechanically ventilated patients in the intensive care unit


Author(s):

Samaa Rashwan, Hatem El moutaz Mahmoud, Zeinab Taha



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