Clinical effectiveness of a sedation protocol minimizing benzodiazepine infusions and favoring early dexmedetomidine: a before-after study

Table 5 Potential adverse effects

Outcome	Both phases combined (n =199)	Before (n =97)	After (n =102)	P -value^a
Addition of vasopressor, n (%)	35	25 (26%)	10 (10%)	0.0031
While on midazolam	20 (57%)	16 (16%)	4 (4%)
While on propofol	7 (20%)	7 (7%)	0
While on dexmedetomidine	6 (17%)	2 (2%)	4 (4%)
While receiving multiple sedatives	1 (3%)	0	1 (1%)
While off sedation^b	1 (3%)	0	1 (1%)
Increased dose of vasopressor,^c n (%)	45	23 (24%)	22 (22%)	0.718
While on midazolam	21 (47%)	17 (18%)	4 (4%)
While on propofol	10 (22%)	4 (4%)	6 (6%)
While on dexmedetomidine	10 (22%)	2 (2%)	8 (8%)
While receiving multiple sedatives	1 (2%)	0	1 (1%)
While off sedation^b	3 (7%)	0	3 (3%)
Addition of inotrope, n (%)	9	6 (6%)	3 (3%)	0.151
While on midazolam	5 (56%)	3 (3%)	2 (2%)
While on propofol	3 (33%)	3 (3%)	0
While on dexmedetomidine	1 (1%)	0	1 (1%)
While receiving multiple sedatives	0	0	0
While off sedation^b	0	0	0
Heart rate <50 beats/min, n (%)	25	14 (14%)	11 (11%)	0.438
While on midazolam	5 (20%)	4 (4%)	1 (1%)
While on propofol	9 (36%)	6 (6%)	3 (3%)
While on dexmedetomidine	7 (28%)	3 (3%)	4 (4%)
While receiving multiple sedatives	2 (8%)	1 (1%)	1 (1%)
While off sedation^b	2 (8%)	0	2 (2%)

^a P-value is for the before versus after phase comparison. ^bPotential adverse effect occurred during a period of time when no continuous sedation was being administered (for example, during a sedative interruption or patient may have only been receiving analgesia at that time). ^cIncreased dose was defined as an increase from baseline dose of ≥5 μg/min of norepinephrine or ≥50 μg/min for phenylephrine.

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