Abstract: Objective: To investigate the sedative effect and safety of dexmedetomidine for patients with indwelling nasal tracheal duct in the intensive care unit (ICU) after oral forearm flap repair. Methods: Forty patients with oral nasal tracheal ducts who underwent oral forearm flap repair were divided into two groups randomly. The sedative drug onset time to reach the target sedation range and the time the patients were awake after the drug had been withdrawn were recorded. The total dosage of the sedative drug for both groups was recorded. The Ramsay sedation scores before using sedative (T₀), 30 min (T₁), 1 h (T₂), 2 h (T₃), 6 h (T₄), and 12 h (T₅) after injection of sedative and 10 min (T₆) after extubation were recorded. The incidence of respiratory depression, and bradycardia and hypotension was recorded. The incidence of delirium was recorded. The mortality during treatment was recorded. Results: Midazolam and dexmedetomidine both resulted in a Ramsay score within 2-4. The recovery time of dexmedetomidine was significantly faster than that of midazolam (P＜0.05). The total dosage of analgesics required in the dexmedetomidine group was less than that in the midazolam group (P＜0.05). Midazolam may be more likely to cause respiratory depression (P＜0.05). The number of patients who have delirium in midazolam group was significantly lower than that in the dexmedetomidine group (P<0.05). Conclusion: In a certain range of dosage, dexmedetomidine and midazolam can meet the needs for sedation in ICU patients. And dexmedetomidine has analgesic effect. Dexmedetomidine can reduce the incidence of delirium in ICU patients.

Key words: Dexmedetomidine, Midazolam, Sedation, Analgesic