Key result
Dexmedetomidine reduced the requirement for rescue midazolam by 80% (4.9 vs 23.7 microg/kg/h, p<0.0001) and morphine by 50% (11.2 vs 21.5 microg/kg/h, p=0.0006) compared to placebo.
Why the study?
Does dexmedetomidine reduce the need for rescue sedation and analgesia in postoperative cardiac and general surgical patients requiring ventilation in the ICU?
RCT (n=105)
Randomized
Yes
Does dexmedetomidine reduce the need for rescue sedation and analgesia in postoperative cardiac and general surgical patients requiring ventilation in the ICU?
Dexmedetomidine significantly reduces the requirement for rescue midazolam and morphine in postoperative ventilated patients.
Supports dexmedetomidine to minimize rescue sedation and analgesia in ventilated postoperative ICU patients; confirms RCT benefits in cardiac and general surgical cohorts.
Dexmedetomidine, a highly selective and potent alpha2-adrenergic agonist, has a potentially useful role as a sedative agent in patients requiring intensive care. As part of a larger European multicentre trial, a total of 119 postoperative cardiac and general surgical patients requiring ventilation and sedation in an intensive care unit were enrolled in four centres in the United Kingdom. One hundred and five patients were randomly allocated to receive either dexmedetomidine or placebo with rescue sedation and analgesia provided by midazolam and morphine, respectively. Compared with the control group, intubated patients receiving dexmedetomidine required 80% less midazolam [mean 4.9 (5.8) microg.kg-1.h-1 vs. 23.7 (27.5) microg.kg-1.h-1, p < 0.0001], and 50% less morphine [11.2 (13.4) microg.kg-1.h-1 vs. 21.5 (19.4) microg.kg-1.h-1,p = 0.0006]. Cardiovascular effects and adverse events could be predicted from the known properties of alpha-2 agonists. In conclusion, dexmedetomidine is a useful agent for the provision of postoperative analgesia and sedation.
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Venn et al. (1999) conducted an RCT in Postoperative requiring ventilation and sedation (n=105). Dexmedetomidine vs. Placebo was evaluated on Midazolam requirement (microg.kg-1.h-1) (80% reduction, p=< 0.0001). Dexmedetomidine reduced the requirement for rescue midazolam by 80% (4.9 vs 23.7 microg/kg/h, p<0.0001) and morphine by 50% (11.2 vs 21.5 microg/kg/h, p=0.0006) compared to placebo.
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