ABSTRACT
The main goals of intraoperative sedation are anxiolysis, hypnosis and amnesia. These objectives are required to produce a calm comfortable, but communicative patient. The sedation of a geriatric represents a continuum. These patients can move easily from light level of sedation to obtundation. The distinction between conscious sedation and deep sedation is made for the purpose of describing the proper level of physiologic monitoring. Midazolam and propofol are the most popular sedative agents due to their attractive pharrnacokinetic profile and wide therapeutic index. This study was carried out on 40 old patients above 60 years scheduled for hip surgical correction under spinal anaesthesia. They were randomely class into two equal groups according to the sedative regimen used. The propofol was used in one group at initial dose 1-1.5 mg/kg followed by ascending infusion scale5-50 ug/ kg/min. every 5 minutes. The midazolam was used in the second group at initial dose 10-20 ug/kg followed by ascending infusion scale 0.2-2 ug/kg/min every 5 minutes. The infusion rate adjusfed till reach the optimum sedation score [=3] in both groups. Sedation and recovery [durations and degrees] were assessed by Ramsay sedation scale and recovery room score respectively. The haemodynamics and concomitent events were recorded. This study showed the sign lower haemodynamic data of propofol group in comparison with the midazolam one, but with superior titrability, at the optimum sedation level, and faster recovery time. The midazolam group is superior in its amnestic action with less paradoxical agitation but with delayed recovery and difficult titrability at the desired sedation level like propofol