Abstract

Objective
The aim of this study was to evaluate the correlation of sedation with subjective clinical sedation scores and compare plasma cortisol levels as an objective marker between two groups: patients sedated with dexmedetomidine alone and patients sedated with a combination of dexmedetomidine and magnesium, in mechanically ventilated patients.
Materials and Methods
A total of 50 patients were enrolled and divided into two groups. Group 1(dexmedetomidine group) received a loading dose of 1μg/kg, followed by a continuous infusion of 0.2-1.4 μg/kg/hour for 24 hours. Group 2(dexmedetomidine+magnesium group) received a loading dose of 1 μg/kg of dexmedetomidine, followed by a continuous infusion of 0.2-1.4 μg/kg/hour for 24 hours, along with two bolus doses of 2 grams of magnesium and a continuous infusion of 16mg/24 hours. Sedation scale scores, Glasgow coma scores, heart rate, and plasma cortisol levels at baseline and at 24 hours were recorded throughout the 24-hour study period.
Results
At 24 hours, cortisol levels were significantly lower in Group 2(p < 0.05). Heart rate was significantly lower in Group 2, except at baseline(p < 0.05). No significant differences between the groups regarding sedation scale scores or Glasgow coma scores(p > 0.05) were found.
Conclusion
Although adding magnesium to dexmedetomidine provided sufficient sedation and may have enhanced compliance with mechanical ventilation, no statistically significant difference was observed in achieving the target sedation levels in a clinical setting.

Key words: Intensive care, sedation, dexmedetomidine, magnesium, cortisol