Intraoperative Dexmedetomidine Versus Midazolam in Patients Undergoing Peripheral Surgery With Mild Traumatic Brain Injuries: A Retrospective Cohort Analysis.

BACKGROUND

The intra- and postoperative effects of dexmedetomidine are not completely consistent and midazolam/fentanyl is most widely used in peripheral surgeries. The objectives of the study were to evaluate the sedative, analgesic, hemodynamic, anti-inflammatory, and antioxidant effects of dexmedetomidine against midazolam in patients undergoing peripheral surgeries with mild traumatic brain injuries.

METHODS

Medical records of patients who underwent peripheral surgeries with mild traumatic brain injury were included in the analysis. Patients received intraoperative midazolam (MDZ cohort, n = 225) or dexmedetomidine (DEX cohort, n = 231). Pre-, intra-, and postoperative characteristics of patients were collected and analyzed.

RESULTS

After administration of anesthesia, up to 40 minutes, patients of the MDZ group had lower modified observer's assessment of alertness/sedation score than those of the DEX group ( = .041), but after 40 minutes, patients of the MDZ group had a higher score than those of the DEX group throughout surgeries ( = 0.048). The DEX group has less requirements of postoperative morphine/equivalent doses than the MDZ group (4 ± 1 vs 5 ± 1, < .0001, = 18.451).

CONCLUSIONS

Intraoperative DEX offers better sedation, postoperative analgesia, and clinical recovery for peripheral surgeries and suppresses inflammatory response.

LEVEL OF EVIDENCE

III.