Comparing the effects of tapering fentanyl and midazolam vs changing fentanyl and midazolam to dexmedetomidine on restlessness of patients being weaned from ventilator in PICU

Abstract

Introduction: Nowadays, due to possibility of physical and mental consequences as a result of long-term pain and anxiety experienced by hospitalized patients in PICU and under ventilation, they have to use sufficient and appropriate dose of sedative and analgesic drugs, so this clinical study is important.Objectives: Investigating the effects of dexmedetomidine in reducing restlessness symptoms in under ventilation patients receiving midazolam and fentanyl drugs.Methods: The study was conducted in a double blind way, that is, the researcher, the patient, the clinical caregiver and the outcome evaluator were blinded. The study was conducted in two groups of 10 people, in 10 patients who were treated with midazolam and fentanyl for more than 5 days, 10 to 25% per day was reduced based on the patient's tolerance. In the other 10 patients, 24 hours before stopping midazolam and fentanyl, dexmedetomidine was started at a dose of 0.2-0.5 mcg/kg/hour, after 24 hours, midazolam and fentanyl were stopped, and then dexmedetomidine was administered at a dose of 0.1 mcg/hour. Kg/h was reduced every 12 to 24 hours based on the patient's tolerance.Results: Dexmedetomidine can reduce symptoms of restlessness in patients who are being weaned from ventilators and have been treated with fentanyl and midazolam. And it can also reduce the time needed to successfully wean patients from the ventilator compared to slowly reducing the dose of midazolam and fentanyl drugs.Conclusion: Dexmedetomidine can reduce symptoms of restlessness in patients who are being weaned from ventilators and have been treated with fentanyl and midazolam. And it can also reduce the time needed to successfully wean patients from the ventilator compared to slowly reducing the dose of midazolam and fentanyl drugs.