Wesley Kafka, PharmD, BCCCP, MBA,
Critical Care Clinical Pharmacy Specialist
Charleston Area Medical Center
Charleston, West Virginia
Disclosure information not submitted.
Charles Baddour, BSPS, PharmD
PGY2 Critical Care Pharmacy Resident
Charleston Area Medical Center, United States
Disclosure information not submitted.
Apexa Patel, n/a
Research Associate
Charleston Area Medical Center, United States
Disclosure information not submitted.
Title: Prospective review of opioid requirements in MICU patients sedated on dexmedetomidine or propofol
Introduction: This study analyzed the total opioid consumption of medical ICU patients sedated on either dexmedetomidine or propofol to assess for a difference in total oral morphine milligram equivalents consumed while on continuous sedation.
Methods: This study was a prospective, cohort study that analyzed patients who received continuous sedation, via propofol or dexmedetomidine, while mechanically ventilated. Patients were cared for at either Charleston Area Medical Center Memorial Division or General Division between August 1st, 2020 and October 31st, 2020. Patient’s past medical history and admitting diagnosis were documented from the chart. Patient’s continuous sedation medication and rate of infusion were documented from the chart and from the continuous infusion IV pumps on the floor.
Results: In total, 63 patients were included with 41 patients sedated using propofol and 12 patients sedated using dexmedetomidine. There was no difference in oral morphine milligram equivalents per day between dexmedetomidine and propofol group (263.02 MME vs. 210.53 MME, p=0.998). The rate of reintubation was not significantly different between the two groups (0 vs.7, p=0.334). Total opioid consumption in oral morphine milligram equivalents was not significantly different between the two groups (1061.5 MME vs. 1038.5 MME, p=0.344). Acetaminophen use during continuous sedation did not significantly differ between the two groups (1 vs. 7, p=0.440)
Conclusions: The use of either propofol or dexmedetomidine as a continuous sedative does not seem to be associated with a decrease in daily oral morphine milligram equivalents. Neither propofol nor dexmedetomidine seem to be associated with a difference in reintubation rate, nor does acetaminophen use seem to be associated with a reduction in opioid consumption in medical patients who are mechanically ventilated.