ICU sedation with haloperidol-propofol infusion versus midazolam-propofol infusion after coronary artery bypass graft surgery: A prospective, double-blind randomized study Full Text
Annals of Cardiac Anaesthesia, 07/06/2012
Etezadi F et al. – The authors conclude that haloperidol–propofol infusion decreases propofol requirements in the agitated patients. Besides, this combination showed a better profile in terms of occurrence of respiratory depression.Methods
- The authors hypothesized that combination of haloperidol–propofol in comparison with midazolam–propofol would lower consumption of propofol and lead to better hemodynamic and respiratory profile during sedation of agitated patients.
- Among 108 patients admitted in the ICU, 60 patients were agitated according to Ramsay Sedation Score (RSS) and randomly divided into two groups.
- Morphine sulfate (0.05mg/kg) was administered to all patients for relief of postoperative pain.
- In one group, sedative infusion was started with 1mg/h of haloperidol plus 25µg/kg/min of propofol after bolus injection of 2mg haloperidol.
- In the other group, midazolam1 mg/h and propofol 25µg/kg/min were infused after a bolus injection of 2mg midazolam.
- Propofol infusion was adjusted to keep bi–spectral index between 61–80 and the RSS between 3–5.
- Hourly propofol consumption was recorded during 24h of sedation and compared statistically.
- They also compared SpO2 , arterial blood gas variables, hemodynamic parameters and episodes of respiratory depression (SpO2≤85%) requiring respiratory support between the groups.
- Haloperidol, when added to propofol infusion, decreased its consumption at all the measured times (P=0.001).
- There was no significant difference in hemodynamic variables between two groups, but the episodes of respiratory depression was significantly higher in propofol–midazolam group (P=0.02).