skip to main content

THE EFFECT OF MIDAZOLAM SEDATION ON AGITATION INCIDENCE IN POST-OPERATIVE PATIENTS WHO ARE INTUBATED IN THE ICU OF HOSPITAL HAJI ADAM MALIK MEDAN

Departement of Anesthesiology and Intensive Therapy, University of Sumatera Utara, Indonesia

Received: 22 Nov 2024; Revised: 11 Feb 2025; Accepted: 26 Jun 2025; Available online: 29 Jun 2025.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Citation Format:
Abstract

Background: Agitation in critically ill patients is a phenomenon that can endanger patient safety and assistance during treatment in the intensive care unit. It is characterized by increased motor and mental activity that manifests as inappropriate behavior, disorganized thoughts and loss of self-control over actions.

Objective: Evaluating the effect of midazolam sedation on the incidence of agitation in post-operative intubated patients in the ICU at RSUP Haji Adam Malik, Medan.

Method: This study is a retrospective analytical study with a cross-sectional study design using a scoring approach to determine the relationship between midazolam use and agitation in postoperative patients intubated in the ICU after surgery at HAM General Hospital. The subject selection technique used was non-probability sampling with a consecutive sampling method where 115 subjects were needed. Bivariate analysis for numeric variables used the Independent T-test if the data was normally distributed, or the Mann Whitney U test if the data was not normally distributed. The results of the analysis were said to be significant if p <0.05, with a confidence level of 95%.

Result: The results of the study The dose of midazolam given to postoperative patients intubated in the ICU of Haji Adam Malik General Hospital Medan had a minimum dose of 0.017 mg/kg/hour, a maximum of 0.031 mg/kg/hour and an average of 0.023 mg/kg/hour which was related to the incidence of patient agitation during the ICU obtained a significant relationship p <0.05.

Conclusion: The effect of midazolam sedation on the incidence of agitation in postoperative patients who were intubated in the ICU of RSUP Haji Adam Malik Medan, namely patients who experienced agitation had a statistically significant difference in the dose of midazolam given. And there were side effects of agitation in the form of release of invasive instruments/devices such as endotracheal tubes in patients who did not receive sufficient sedation.

               

Note: This article has supplementary file(s).

Fulltext |  common.other
Untitled
Subject
Type Other
  Download (498KB)    Indexing metadata
Keywords: Midazolam; Agitation; ICU

Article Metrics:

  1. De Almeida TML, De Azevedo LCP, Nosé PMG, De Freitas FGR, Machado FR. Risk factors for agitation in critically ill patients. Rev Bras Ter Intensiva. 2016;28(4):413-419. doi: 10.5935/0103-507X.20160074
  2. Widyastuti Y, Sari D, Atmojo DD. Agitasi Pasca Anestesi dengan Agen Sevoflurane. J Komplikasi Anestesi. 2016;3(2):65-70
  3. Jin H, Yeol-Hyo, Kyoung J, Won S. Analysis of risk factors for emergence agitation in adults undergoing general anesthesia for nasal surgery. Clin Exp Otorhinolaryngol. 2015;29(21):1881-1885
  4. Wei B, Feng Y, Chen W, Ren D, Xiao D, Chen B. Risk factors for emergence agitation in adults after general anesthesia: A systematic review and meta‐analysis. Acta Anaesthesiologica Scandinavica. 2021 Jul;65(6):719-29
  5. Shahhosseini S, Boldaji HN, Shetabi H, Shafa A. Comparative Study of the Effect of Two Different Doses of Dexmedetomidine to Prevent Emergence Agitation in Tonsillectomy in Children Aged 2 to 12 Years Old. Adv Biomed Res. 2023;12(1):57. doi: 10.4103/abr.abr_30_21
  6. Zhou W-J, Liu M, Fan X-P. Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial. Exp Ther Med. 2020;21(2):1-8. doi: 10.3892/etm.2020.9297
  7. Sampurnanand, Chilana D, Sinha AK. A Comparative Study Of Dexmedetomidine And Midazolam For Sedation In Patients On Mechanical Ventilation In Icu Sampurnanand1,. Int J Acad Med Pharm. 2017;6(30):2415-2418. doi: 10.14260/jemds/2017/521
  8. Kusnugroho D, Pardede B. Pencegahan Emergence Agitation Pasca-operasi pada Pasien Anak. Cermin Dunia Kedokt. 2020;47(1):16-23
  9. Erol MK; Kankilic N; Kay F. The effect of midazolam on delirium in patients undergoing coronary artery bypass surgery. Annals of Medical Research. 2020;27(3):921-5
  10. Lee SJ & Sung TY. Emergence agitation: current knowledge and unresolved questions. Korean J Anesthesiol. 2020 Dec;73(6):471-485. doi: 10.4097/kja.20097.Epub2020Mar25.PMID:32209961;PMCID:PMC7714637
  11. El-Din TMN; Sharaf MS; Alkumity AA; Elgammal ME; Salem EA. Midazolam versus Nalpubhine on Prevention of Emergence Agitation in Pediatric Patients on Sevoflurane Anesthesia. Al-Azhar Med J. 2018; 47(3): 573-585
  12. Huang C; Li Z; Long Y; Li D; Huang M; Ding B; et al. A comprehensive evaluation between dexmedetomidine and midazolam for intraoperative sedation in the elderly: protocol for a systematic review and meta-analysis of randomized controlled trials. Syst Rev. 2022 Dec 23;11(1):278. doi: 10.1186/s13643-022-02144-7.PMID:36564829;PMCID:PMC9784254
  13. Song Y; Gao S; Tan W; Qiu Z; Zhou H; Zhao Y. Dexmedetomidine versus midazolam and propofol for sedation in critically ill patients: Mining the Medical Information Mart for Intensive Care data. Ann Transl Med. 2019 May;7(9):197. doi: 10.21037/atm.2019.04.14.PMID:31205915;PMCID:PMC6545304
  14. Temesgen N, Chekol B, Tamirie T, Eshetie D, Simeneh N, Feleke A. Adult sedation and analgesia in a resource limited intensive care unit – A Systematic Review and evidence based guideline. Ann Med Surg. 2021;66(April):102356. doi: 10.1016/j.amsu.2021.102356
  15. Zhou Y; Jin X; Kang Y; Liang G; Liu T; Deng N. Midazolam and propofol used alone or sequentially for long-term sedation in critically ill, mechanically ventilated patients: a prospective, randomized study. Crit Care. 2014 Jun 16;18(3):R122. doi: 10.1186/cc13922.PMID:24935517;PMCID:PMC4095601

Last update:

No citation recorded.

Last update: 2025-07-03 02:52:01

No citation recorded.