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

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 with the objective of comparing 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 a 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. Afterwards, 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 in terms of hemodynamic parameters (P > 0.05) levels of biochemical parameters including Ca (P=0.86), Alb (P=0.34), BE (P = 0.26) MG (P=0.44), HCO3 (P=0.51), Po2 (p=0.32), between the two groups 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 The (P=0.008) and higher sedation (p=0.03) was 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. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved.