Background and Aims: Abdominal sepsis serves as a significant challenge in critical care and frequently requires mechanical ventilation (MV) and sedation to ensure patient satisfaction and promote recovery. The present research compared the effect of dexmedetomidine, haloperidol, and propofol on intra-abdominal pressure (IAP), inflammatory markers, and clinical outcomes in abdominal septic cases. Methods: This randomised controlled trial enroled 90 adult abdominal sepsis patients requiring postoperative MV. Patients were randomised to three groups: Group D received intravenous (IV) dexmedetomidine (1 μg/kg loading dose over 10 min; 0.2–0.3 μg/kg/h maintenance), Group H was administered IV haloperidol (2.5 mg loading dose; 1–2 mg/h infusion), and Group P received IV propofol (1 mg/kg loading dose over 15 min; 20–80 μg/kg/min maintenance). The primary outcome was the serum interleukin (IL)-6 level at 24 hours. Data were analysed using one-way analysis of variance (ANOVA), Tukey’s post hoc test, Kruskal–Wallis test, or Chi-square test as appropriate, with a P value <0.05 considered significant. Results: Dexmedetomidine significantly reduced interleukin (IL-6, IL-8), serum lactate, and IAP at 24 and 48 h ( P < 0.05), showing superior efficacy than haloperidol, which was more effective than propofol. Groups D and H demonstrated better haemodynamic stability than propofol. There were no notable variations in the duration of MV, intensive care unit, hospital stay, or mortality rates among the groups. Conclusion: Dexmedetomidine exhibited superior anti-inflammatory effects and better control of IAP than haloperidol and propofol in abdominal sepsis patients. However, these physiological improvements did not translate into significant differences in clinical outcomes.
Arafa et al. (2026) studied this question.