PROPOFOL VS MIDAZOLAM

SEDATION IN MECHANICALLY VENTILATED PATIENTS

Abstract

Objective: A study was conducted to evaluate the benefits of propofol versus midazolam for
providing ICU sedation in mechanically ventilated patients. Design: An observational analytical study. Place and
Duration: The study was conducted at CMH Rawalpindi and PNS Shifa Hospital Karachi, from February 2000 to July
2001 in the Department of Anaesthesia and Intensive Care. Subjects and Methods: Propofol and midazolam infusions
were administered to two randomly distributed groups of patients (n=25, each group) who received standardized
dosage of morphine chloride and muscle relaxant. Patients were thoroughly evaluated for haemodynamic alterations
caused by both the drugs, in terms of heart rate and blood pressure variability. A commercially available program was
used to assess the statistical analysis of data (SPSS for Windows 8.0, Standard version, and www.SPSS.com).
Results: No significant differences were found in age (p=.837), gender (p=.763), and weight distribution (p=.827). The
time under sedation was longer for the group on midazolam than for the group administered with propofol (p=.001);
but it did not affect the overall length of stay in ICU to the same extent (p=.028) or the patients’ outcome. Mean daily
dosage of the sedative agent (mg/day) and total dose administered to the patients, were also significantly higher for
group on propofol (p=.000). Wake-up time after stopping infusions of sedative drugs, was shorter in the group on
propofol (p=.000). In both groups, most of the haemodynamic variables did not show significant difference (p=.274 -
.916) except maximum systolic (p=.000) and maximum mean (p=.009) blood pressures, which are lower in the group
receiving propofol. Conclusions: Midazolam and propofol were similar in providing haemodynamic stability to our ICU
patients. With midazolam, there were less therapeutic failures; while propofol offered shorter wake-up times. More
research is needed to determine the most effective agent to sedate ICU patients.