Perbandingan Kejadian Agitasi pada Pasien di Intensive Care Unit (ICU) pada Pemberian Dexmedetomidine dan Midazolam yang Diukur dengan Penggunaan Richmond Agitation Sedation Scale (RASS) dan Bispectral Index (BIS)

Abstract

Introduction: Mechanical ventilation in critically ill patients often leads to agitation in the ICU. Sedation-analgesia therapies like midazolam and dexmedetomidine are commonly used to manage this agitation. This study aims to compare the incidence of agitation in ICU patients receiving dexmedetomidine and midazolam, with measurements taken using the Richmond Agitation Sedation Scale (RASS) and Bispectral Index (BIS). Methods: This randomized, double-blind clinical trial included 26 intubated ICU patients, divided into two groups: Group M (midazolam 0.04 mg/kg/hour) and Group D (dexmedetomidine 0.4 mcg/kg/hour). Sedation depth was measured at four time points: T0 (before intervention), T1 (after 4 hours), T2 (after 8 hours), and T3 (after 24 hours) using RASS and BIS. Results: The sample consisted of 57.1% males, with an average age range of 45-59 years, and 35.7% had a high school education. Group M exhibited higher agitation levels at T3 and T4 based on RASS and BIS scores compared to Group D (p<0.05). However, Group D showed more fluctuation in hemodynamic parameters. Strong correlations between RASS and BIS scores were observed at T4 in both groups (r<0.8; p<0.05). Conclusion: Dexmedetomidine is more effective than midazolam in reducing agitation in mechanically ventilated ICU patients.