Aim: To study the Comparison of Dexmedetomidine, midazolam and propofol for sedation of post operative patients on mechanical ventilation. Methods: This single blinded, open label, randomized control trial conducted in Intensive care unit, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. 45 patients were equality divided into 3 groups, 15 in each groups. Primary variable will be sedation of the patient. Sedation will be assessed by Ramsay Sedation Score. (1=agitated; 2 = cooperative, tranquil; 3=responds to verbal command; 4=brisk response to loud voice or glabellar tap; 5 = sluggish response to glabellar tap or loud voice; 6=no response). Group M: Midazolam loading dose 0.04 mg/kg over 15 minutes, followed by maintenance infusion at a rate of 0.08 mg/kg/h. Group P: Propofol loading dose 1mg/kg over 15 minutes, followed by maintenance infusion at a rate of 1-3 mg/kg/h. Group D: Dexmedetomidine loading dose 1 mcg/kg over 15 minutes, followed by maintenance infusion at a rate of 0.4-0.7 mcg/kg/h. Results: The difference in mean age and ASA status among the three groups are not statistically significant (p= 0.29 & p=0.47). There is no statistical significance of sex & GCS status of the patients of these three groups(p= 0.49 & p=0.47). We found mean post sedation delirium was not statistically significant (p=0.078). No statistical significant difference in SBP & DBP among all these groups. There is statistically significant difference in mean RSS at 5 min interval in group D. At 25 & 30 min interval it was higher in group P and at 60 min it was higher in group M and these are statistically significant (p<0.005). In our study the mean Opioid at 24th hour is more in Midazolam group and it is significantly less in patients receiving dexmedetomidine. In our study we found that difference of mean HR at different time interval was not statistically significant but compared to group M & P, HR falls more in group D and the mean HR is less in Dexmedetomidine group. Conclusion: Dexmedetomidine is safer and equally effective agent compared to propofol and midazolam for sedation of neurosurgical mechanically ventilated patients with good hemodynamic stability and extubation time as rapid as propofol.

Aim: To study the Comparison of Dexmedetomidine, midazolam and propofol for sedation of post operative patients on mechanical ventilation. Methods: This single blinded, open label, randomized control trial conducted in Intensive care unit, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. 45 patients were equality divided into 3 groups, 15 in each groups. Primary variable will be sedation of the patient. Sedation will be assessed by Ramsay Sedation Score. (1=agitated; 2 = cooperative, tranquil; 3=responds to verbal command; 4=brisk response to loud voice or glabellar tap; 5 = sluggish response to glabellar tap or loud voice; 6=no response). Group M: Midazolam loading dose 0.04 mg/kg over 15 minutes, followed by maintenance infusion at a rate of 0.08 mg/kg/h. Group P: Propofol loading dose 1mg/kg over 15 minutes, followed by maintenance infusion at a rate of 1-3 mg/kg/h. Group D: Dexmedetomidine loading dose 1 mcg/kg over 15 minutes, followed by maintenance infusion at a rate of 0.4-0.7 mcg/kg/h. Results: The difference in mean age and ASA status among the three groups are not statistically significant (p= 0.29 & p=0.47). There is no statistical significance of sex & GCS status of the patients of these three groups(p= 0.49 & p=0.47). We found mean post sedation delirium was not statistically significant (p=0.078). No statistical significant difference in SBP & DBP among all these groups. There is statistically significant difference in mean RSS at 5 min interval in group D. At 25 & 30 min interval it was higher in group P and at 60 min it was higher in group M and these are statistically significant (p<0.005). In our study the mean Opioid at 24th hour is more in Midazolam group and it is significantly less in patients receiving dexmedetomidine. In our study we found that difference of mean HR at different time interval was not statistically significant but compared to group M & P, HR falls more in group D and the mean HR is less in Dexmedetomidine group. Conclusion: Dexmedetomidine is safer and equally effective agent compared to propofol and midazolam for sedation of neurosurgical mechanically ventilated patients with good hemodynamic stability and extubation time as rapid as propofol.