Comparison of Fentanyl-Magnesium Sulfate vs Fentanyl-Midazolam on Sedation and Hemodynamic Changes in ICU Patients Under Mechanical Ventilation

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associated Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Anesthesia Resident, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Sedation in patients, especially in those admitted to the Intensive Care Unit (ICU), can result in lower levels of anxiety. This study was performed to compare the degree of sedation and hemodynamic stability in two combinations, including fentanyl-magnesium sulfate and fentanyl-midazolam, in patients under mechanical ventilation in the ICU.
Methods: The study is a triple-blind clinical trial without control, which was performed in Isfahan on 40 patients admitted to the ICU and required respiratory support for at least 12 to 24 hours. The patients were placed on sedation with two drug combinations, including midazolam- fentanyl (group 1) and magnesium sulfate- fentanyl (group 2), in a completely random and simple method. Afterward, during the first 24 hours, the severity of illness based on the APACHE II scale, degree of sedation based on the Richmond scale (RASS), severity of pain, hemodynamic stability, and various biochemical parameters were measured and recorded systematically.
Findings: There were no significant differences between the two groups in terms of hemodynamic indicators (P > 0.05), surgical duration (P = 0.16), recovery time (P = 0.11), and biochemical parameters levels of CA (P = 0.86), ALB (P = 0.24), PH (P = 0.33), PCO2 (P = 0.51), HCO3 (P = 0.25), PO2 (P = 0.32), BE (P = 0.26), and MG (P = 0.44). The APACHE scores before treatment (P = 0.33) and after treatment (P = 0.77) were not different between two the groups. A lower intensity of pain (P = 0.008) and higher sedation (P = 0.03) were observed in the magnesium sulfate group.
Conclusion: Magnesium Sulfate plus fentanyl, compared to a combination of midazolam-fentanyl, had a more prominent (suitable) effect on the degree of sedation and pain control in patients under mechanical ventilation.  Hemodynamic stability was seen in both groups.

Highlights

Parviz Kashefi:  PubMed ,Google Scholar

Behzad Nazemroaya: PubMed , Google Scholar 

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References

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Journal of Isfahan Medical School
Volume 42, Issue 793
1st Week, February
January and February 2025
Pages 1053-1060

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History

  • Receive Date: 27 April 2024
  • Revise Date: 28 December 2024
  • Accept Date: 31 December 2024

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