Khawar Aziz.
Propofol vs midazolam.
Professional Med J Jan ;12(3):260-6.

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.

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