Background: Dexmedetomidine facilitates patient communication with the ICU nurses, and is a valuable drug for use in patients undergoing mechanical ventilation due to a reduction in the duration of mechanical ventilation and prevalence of delirium. Objectives: In this study, investigators aimed to compare the effect of Dexmedetomidine with placebo on sedation in patients undergoing open-heart surgery. Methods: In this double-blind clinical trial, 69 patients with open-heart surgery who underwent a cardiopulmonary bypass pump, were randomly assigned into two groups of Dexmedetomidine (group D) and placebo (group P). At the end of the operation, patients in groups D and P respectively received 1 µ / kg infusion of Dexmedetomidine and normal saline in 10 minutes. In case of a lack of proper sedation, midazolam with the doses of 1 mg titration was used up to reaching the goal of sedation. Also, for pain relief, morphine titrated at a dose of 1 mg was Injected, and dosage was recorded in both groups. In each shift, patients were examined for delusions by the nurse involved in their care, using the “Confusion Assessment Method for the ICU (CAM-ICU)”. For patients with delirium, 1 to 5 mg of Haloperidol was used. Also, the length of stay in the ICU was recorded. Results: There was no significant difference between the two groups in systolic blood pressure, diastolic blood pressure, and heart rate at different stages of treatment (p<0.05). comparison of the two groups in terms of the length of stay in ICU, duration of mechanical ventilation, staff satisfaction, and occurrence of Delirium after surgery indicated that there were significant differences between the two groups (p<0.05). There was a significant difference between the two groups in the dose of morphine and midazolam (p<0.05). Conclusion: This study showed that sedation with Dexmedetomidine significantly reduced the incidence of postoperative delirium, the length of stay in ICU, the duration of mechanical ventilation, the satisfaction rate of ICU staff, and the dose of analgesic and sedative medication. As there were no reported hemodynamic complications as well, it seems that it can be indicated as a safe and appropriate drug for sedation of patients in the ICU.
Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
