Comparison of the effects of Propofol, Dexmedetomidine and Midazolam on Sedation and Oxidative-Antioxidant System in Critically ill Patients

Abstract

Purpose: This study aimed to compare the impact of midazolam, propofol, dexmedetomidine infusions for 24^th hour on total antioxidant status (TAS), total oxidant status (TOS), oxidative stres index (OSI) and prolidase levels.

Material/Metots: 75 patient ICU patient who were mechanically ventilated enrolled to the study. Patients randomised to three groups. Group I (n=25, midazolam): 0.02 mg/ kg/h midazolam, Group II (n = 25, propofol): 1mg/kg/h propofol, Group III (n=25, dexmedetomidine): 0.2 µg/ kg/h dexmedetomidine infusions was started. Dosage were arrange to achieve Ramsay sedation score 3. Blood samples were collected in basal, 6.,12.,18., 24. hour, and hemodynamic parameters were also recorded in the same time intervals.

Results: In midazolam group 24. hour TAS levels were significantly decreased and TOS, prolidase and OSI levels were significantly increased compared to the basal level (p<0.05). 24. hour TAS levels were significantly decreased and TOS, prolidase and OSI levels were significantly increased compared to basal level in propofol group (p<0,05). In dexmedotimidine groups 24.hour TAS and prolidase levels were significantly decreased, OSI levels were increased compared to the basal levels (p<0.05). Increase in TOS levels were not statistically significant (p>0.05). Basal TAS, TOS, prolidase, OSI levels were not statistically significantly between the different groups (p>0.05).

Conlusions: According to the study results, there were no statistically significant differences between the groups. Among hemodynamic parameters Dexmedetomidine was found to be having statistically significant favorable results in comparison to others. However         there results should be clinically and molecularity verified with large scale further studies