[Comparison of the activity and reliability of intravenous administration of midazolam and dexmedetomidine on sedation levels under epidural anesthesia].
OBJECTIVE
We aimed to assess the sedative effects of midazolam and dexmedetomidine and their effects on hemodynamics and the cardiovascular system under epidural anesthesia.


METHODS
This study included 50 patients. Approval of the ethics committee and written consent from patients were obtained. The patients were separated into two groups to receive dexmedetomidine (D group) or midazolam (M group). Perifix no. 18 was placed in the epidural space from the L(3-4) interspace. After lidocaine 60 mg/3 ml was applied, isobaric bupivacaine 0.5% was given as 1 ml per segment. After block reached the T10 level, midazolam was given to the M group as a bolus of 0.015 mg kg(-1) in 10 minutes until beginning the operation, followed by continuous infusion as 0.1-0.2 mg kg(-1)h(-1) dosage. Dexmedetomidine 1 mcq kg(-1) was given to the D group as a bolus dosage in 10 minutes until beginning the operation, followed by continuous infusion as 0.4-0.7 mcq kg(-1) h(-1) dosage. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), SpO(2), Ramsay Sedation Score (RSS), bispectral index (BIS), and respiratory rate (RR) were recorded. Sedative infusion was stopped when skin suture was closed. Adverse effects were also recorded.


RESULTS
In group D, MAP was significantly higher and HR was significantly lower than in group M (p<0.05).


CONCLUSIONS
We concluded that both drugs provided good sedation with no respiratory depression, stable hemodynamics and alertness with good cooperation. However, we consider midazolam as the first option due to its cost benefit.
Kuzucuoğlu
Tamer
T
1st Department of Anesthesiology and Reanimation, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey. tamer.kuzucuoglu@sbkeah.gov.tr
Bölükbaşıoğlu
Ilhan
I
Arslan
Gülten
G
Yücel
Emre
E
Ayaz
Betül
B
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D017558:Elective Surgical Procedures; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use; D007044:Hysterectomy; D007262:Infusions, Intravenous; D008874:Midazolam / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008875:Middle Aged; D056152:Respiratory Rate / Q000187:drug effects / Q000502:physiology
D018712:Analgesics, Non-Narcotic; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam; D002045:Bupivacaine