Heart Rate and Blood Pressure Status of Mechanically Ventilated Patients Taking Dexmedetomidine for Sedation and Analgesia

Résumé

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). But in Bangladesh we have very few research-oriented data regarding the heart rate and blood pressure status of mechanically ventilated patients taking dexmedetomidine for sedation and analgesia. Aim of the study: The aim of this study was to assess the heart rate and blood pressure status of mechanically ventilated patients taking dexmedetomidine for sedation and analgesia. 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. 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: In this study we observed group A patients treated with dexmedetomidine for sedation and analgesia were significantly more prone to develop hypotension and bradycardia where the P value was found <0.05. However, there had no statistically significant difference in developing hypertension and tachycardia between the groups (p>0.05). 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). The effectiveness of dexmedetomidine was found satisfactory. Conclusion: Although dexmedetomidine provides satisfactory results to mechanically ventilated patients for sedation and analgesia physicians should aware about possible hypotension and bradycardia.