Jul 2026· International Journal of Pharmaceutical Quality Assurance· 0 citations· 18 references
TL;DR
Both agents are effective for short procedural sedation, whereas propofol ensures faster recovery, and Dexmedetomidine offers superior cardiorespiratory stability, whereas propofol ensures faster recovery.
Abstract
Background: “
Dexmedetomidine and propofol are widely used intravenous sedatives for short procedures
requiring rapid onset, adequate sedation depth, hemodynamic stability, and early recovery. Their distinct
pharmacological profiles influence clinical outcomes.
Aim: To compare the efficacy, hemodynamic effects, recovery characteristics, adverse events, and satisfaction
outcomes of dexmedetomidine versus propofol for sedation in short procedures.
Methodology: This prospective, randomized comparative study included 90 ASA I–II patients (18–60 years)
undergoing elective short procedures (≤60 minutes) under monitored anesthesia care. Patients were allocated into
Group D (dexmedetomidine, n=45) and Group P (propofol, n=45). Hemodynamic parameters, Ramsay Sedation
Score, recovery time (Aldrete score ≥9), adverse events, and satisfaction scores were assessed and analyzed using
SPSS v27.
Results: Demographic characteristics were comparable between groups. Dexmedetomidine showed better
hemodynamic stability with higher minimum MAP (p=0.002) and SpO₂ (p=0.018), and fewer respiratory events
(p<0.05), but more bradycardia (p=0.046). Propofol provided faster onset (p=0.001) and shorter recovery time
(p=0.001). Sedation depth was comparable. Surgeon satisfaction was significantly higher with dexmedetomidine
(p=0.009).
Conclusion: Both agents are effective for short procedural sedation. Dexmedetomidine offers superior
cardiorespiratory stability, whereas propofol ensures faster recovery. Agent selection should be individualized.
Objectives: The objective of the study was to assess the effectiveness and safety of dexmedetomidine versus midazolam for sedation during regional anesthesia surgery.
Methods: This prospective randomized comparative interventional study was conducted in the Department of Anesthesiology at a tertiary care hospital from January 2025 to January 2026. 100 adult patients undergoing elective surgeries under regional anesthesia were randomly divided into two groups: Group D (dexmedetomidine, n=50) and Group M (midazolam, n=50). Richmond agitation sedation scale (RASS) was used to evaluate sedation. Intraoperative monitoring of hemodynamic parameters, such as mean arterial pressure and heart rate, was performed. Recovery characteristics, patient satisfaction, requirement for rescue sedation and adverse effects were also assessed.
Results: The mean intraoperative RASS score was significantly lower in the Group D than in the Group M (−2.8±0.5 vs. −2.5±0.7; p=0.02). The time required to reach the target sedation level was significantly greater in Group D (9.4±2.6 min vs. 7.8±2.4 min; p=0.003). The scores of patient satisfaction with dexmedetomidine use were significantly greater than with midazolam use (8.5±1.0 vs. 7.9±1.2; p=0.01). Dexmedetomidine was associated with more adverse effects of bradycardia (p=0.08) and hypotension (p=0.46), whereas midazolam was associated with more adverse effects of excessive sedation (p=0.14) and restlessness (p=0.09).
Conclusion: Dexmedetomidine and midazolam were both found to be effective sedatives for patients undergoing regional anesthetic. Dexmedetomidine was found to be a more effective sedative, well tolerated, more patient-satisfying and more stable for intraoperative hemodynamic despite its comparatively slower onset of sedation than midazolam.
AVINASH KAREKAL, SRINIVAS KURAHATTI, Rashmi C· Asian Journal of Pharmaceuti...· 0 citations
Background: The choice of anesthetic agent for maintenance of general anesthesia significantly influences
intraoperative stability, ‘
recovery profile, and postoperative outcomes. Propofol and sevoflurane are commonly
used agents, yet their comparative performance remains clinically relevant.
Aim: To compare propofol and sevoflurane for maintenance of anesthesia with respect to hemodynamic stability,
recovery characteristics, and adverse events.
Methodology: This prospective, randomized comparative study included 80 ASA I–II patients undergoing
elective surgeries. Patients were allocated into two groups: Group P (propofol infusion) and Group S (sevoflurane
inhalation). Hemodynamic parameters, recovery times, Modified Aldrete Score, and perioperative adverse events
were assessed and analyzed statistically.
Results: Demographic variables were comparable between groups. Group P demonstrated significantly better
intraoperative hemodynamic stability with lower heart rate and blood pressure values (p < 0.05). Recovery was
faster in Group P, with shorter times to eye opening, verbal response, and extubation (p < 0.001). Postoperative
nausea, vomiting, and emergence agitation were significantly lower with propofol.
Conclusion: Propofol provided superior hemodynamic control, faster recovery, and fewer postoperative adverse
effects compared to sevoflurane, making it a preferable agent for maintenance of anesthesia in short elective
surgeries.
Ranjeet Kumar, Faseehullah Alam· International Journal of Pha...· 0 citations
Objective To compare the effects of dexmedetomidine and propofol on early postoperative cognitive function and safety in patients undergoing short-term surgical sedation. Methods This retrospective cohort study included 295 adult patients who received intravenous sedation during non-cardiac surgery (January 2023–January 2025). Patients were divided into dexmedetomidine (n = 150) and propofol (n = 145) groups. Postoperative day 1 outcomes included explicit memory (RAVLT delayed recall) and processing speed (picture naming reaction time). Perioperative hemodynamics, recovery time, and adverse events were recorded. Results On postoperative day 1, the dexmedetomidine group showed higher RAVLT delayed recall scores (8.08 ± 3.06 vs. 7.24 ± 2.82, p = 0.015) but longer picture naming reaction time (881.42 ± 125.34 ms vs. 847.53 ± 118.76 ms, p = 0.037) compared to propofol. Median recovery time was longer with dexmedetomidine (18.00 vs. 14.00 min, p < 0.001). Dexmedetomidine was associated with more bradycardia requiring intervention (p = 0.034), while propofol had more injection pain (p < 0.001). No significant differences were found in hypoxemia or hypotension (p > 0.05). Multivariate analysis identified dexmedetomidine use as an independent factor for higher postoperative RAVLT scores (p = 0.007). Conclusion In this short-term sedation cohort, dexmedetomidine was associated with better explicit memory but slower processing speed and longer recovery versus propofol, with distinct safety profiles. The clinical significance of these small cognitive differences remains uncertain, and prospective validation is needed.
Bojun Zhang, Fan Jia, Ping Li· Frontiers in Medicine· 0 citations
Background: Spinal anesthesia is a very commonly used procedure in modern-day anesthesia practice. Today most of the lower limb surgeries are performed under spinal anesthesia. Midazolam, dexmedetomidine, and fentanyl are common intravenous adjuvants used during anesthesia to allay anxiety and sedation. The aim of this study was to compare the effects of intravenous dexmedetomidine-midazolam versus fentanyl-midazolam in terms of analgesic characteristics, sedation, and adverse effects.
Methods: This is a randomized prospective study that included 35 patients in each group, posted for lower limb orthopedic surgery. Intravenous dexmedetomidine, fentanyl, and midazolam were administered after subarachnoid block. Data for sedation, analgesia, hemodynamic parameters, and adverse effects were recorded.
Results: RR for FM group showed significant intra-group variability in RR across perioperative stages (p<0.05), whereas the DM group maintained greater respiratory stability (p=0.243). HR for DM group exhibited significantly lower intraoperative and postoperative HR compared to FM group (p<0.001), with notable within-group changes, unlike the FM group. MAP for both groups remained stable over time (DM: p= 0.283, FM: p= 0.260), although the FM group had slightly higher values in the postoperative recovery phase. Sedation (RSS): DM produced deeper and more sustained sedation intraoperatively and postoperatively (p<0.001), while FM showed quicker sedation decline. Patient satisfaction was significantly higher in the DM group (VAS: 3.0 vs. 4.0, p= 0.001), although surgeon satisfaction did not differ notably. Adverse events were rare and comparable, though hypotension was more frequent in the DM group (22.9% vs. 8.6%).
Conclusion: Dexmedetomidine plus midazolam provided superior sedation quality and patient satisfaction, with more stable cardiopulmonary parameters during orthopedic surgery under spinal anesthesia. Despite a slightly higher rate of hypotension, DM appears to offer a more favorable sedative profile compared to fentanyl plus midazolam.
M. Rahimi, Mohamad Sorani, Afzal Shamsi et al.· Archives of Anesthesia and C...· 0 citations
Background:Emergence agitation (EA) is a common and distressing complication following sevoflurane anaesthesia in paediatric patients, characterized by non-purposeful restlessness, crying, and disorientation. Dexmedetomidine, a highly selective α2-agonist, is frequently utilized to prevent EA. However, the optimal administration method, rapid intravenous bolus versus continuous intraoperative infusion, remains debated regarding the balance of efficacy and hemodynamic stability.Aims and Objectives:To systematically compare the clinical effectiveness, postoperative recovery profile, and perioperative hemodynamic stability of a rapid bolus versus a continuous low-dose infusion of dexmedetomidine (0.3 μg/kg) in preventing emergence agitation in children undergoing elective abdominal and genitourinary surgeries under sevoflurane anaesthesia.Materials and Methods:This prospective, randomized, double-blind, comparative study enrolled 80 paediatric patients (ASA physical status I–II, aged 2–12 years) randomly allocated into two equal groups (n=40). Group B received IV dexmedetomidine 0.3 μg/kg as a bolus over 10 minutes; Group I received a continuous infusion at 0.3 μg/kg/hour. Intraoperative Heart Rate and MAP were continuously monitored. Postoperative emergence agitation and pain were assessed using the PAED scale and Observational Pain Scores (OPS) in the PACU.Results:Both techniques provided comparable hemodynamic stability. A transient, statistically significant decrease in MAP (p=0.015) was noted at 10 minutes post dexmedetomidine administration in group B, accompanied by a mild, non significant reduction in heart rate (p=0.184); all values remained within 20% of pre-induction baselines without requiring intervention. Group B demonstrated superior early analgesia (OPSon PACU arrival: 1.8 ± 1.2 vs 4.6 ± 1.8; p<0.001). Extubation times (6.2 ± 1.1 vs 6.5 ± 1.4 min; p=0.284) and emergence times (8.1 ± 1.5 vs 8.4 ± 1.8 min; p=0.418) were highly comparable.Conclusion:A 0.3 μg/kg bolus of dexmedetomidine is hemodynamicallysafe and clinically superior to an equivalent continuous infusion. It provides good early postoperative analgesia and effectively mitigates sevoflurane-induced emergence agitation without extending recovery or extubation times.
Sardar Bhagat Singh, Manmohan Jindal, Namrata Jain et al.· Asian Journal of Medical Res...· 0 citations
Background: Induction of general anesthesia in high-
‘
risk patients is often associated with significant
hemodynamic instability. Propofol and etomidate are commonly used induction agents, but their cardiovascular
and endocrine effects differ.
Aim: To compare propofol and etomidate with respect to hemodynamic stability, adverse effects, and stress
hormone response during induction of anesthesia in high-risk patients.
Methodology: This prospective randomized comparative study included 50 ASA II–III patients undergoing
elective surgery under general anesthesia. Patients were randomly allocated to receive propofol (n=25) or
etomidate (n=25) for induction. Hemodynamic parameters (SBP, DBP, MAP), adverse effects, and serum cortisol
levels were recorded at predefined intervals.
Results: Demographic characteristics were comparable between groups. Propofol was associated with a
significant and sustained reduction in SBP, DBP, and MAP following induction and intubation (p<0.001), with a
higher incidence of hypotension (36%). Etomidate maintained better hemodynamic stability but was associated
with myoclonus (20%) and significant transient suppression of serum cortisol levels postoperatively (p<0.001),
which normalized within 24 hours.
Conclusion: Etomidate provides superior hemodynamic stability compared to propofol during induction in highrisk patients, with transient adrenal suppression. It may be preferred when cardiovascular stability is a primary
concern.
Pankaj Kumar, Khushbu Rani, Muni Lal Gupta et al.· International Journal of Pha...· 0 citations