The aim of this study is to compare the efficacy of dexmedetomidine and propofol on decreasing stress in mechanically ventilated patients by using salivary alpha-amylase as a stress marker.
Critically ill patients receiving mechanical ventilation (MV) in the Intensive Care Unit (ICU) have been reported to suffer due to their sense of dependency on technical medical equipment and from severe emotional responses such as hopelessness, anxiety, high levels of frustration and stress. The administration of sedatives is intended to reduce and/or prevent these negative experiences and to facilitate nursing care. Dexmedetomidine is a highly selective α2 receptor agonist with 1600-fold affinity to α1 receptor. The use of dexmedetomidine before anesthesia has a positive effect on hemodynamic stability, which has been associated with reduced postoperative mortality and reduction of unpleasant postoperative complications . Dexmedetomidine has been shown to provide good patient comfort during MV; it also has a satisfactory safety profile and reduces time to extubating. Salivary alpha amylase (SAA) will be considered as a suitable biomarker of sympathetic nervous system activity in recent years. SAA is locally produced by the highly differentiated epithelial acinar cells of the exocrine salivary glands, mostly of the parotid glands and plays an important role in carbohydrate hydrolysis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Patient will receive dexmedetomidine 0.2-1.4 μg/kg/h.
Patient will receive propofol 0.3-4 mg/kg/h.
Tanta University
Tanta, El-Gharbia, Egypt
The level of salivary alpha-amylase.
The level of salivary alpha-amylase will be measured immediately after the mechanical ventilation then after 12h for 2 days.
Time frame: 2 days after intervention
Duration of mechanical ventilation
Time till weaning from mechanical ventilation
Time frame: 28 days after intervention
Intensive care unit length of stay
Time from admission till intensive care discharge
Time frame: 28 days after intervention
Heart rate
Heart rate (HR) will be recorded every 6 hours for 2 days.
Time frame: 2 days after intervention
Mean arterial pressure
Mean arterial pressure (MAP) will be recorded every 6 hours for 2 days.
Time frame: 2 days after intervention
Adverse events
Adverse events Such as hypotension and bradycardia will be recorded.
Time frame: 2 days after intervention
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