Real-World Comparative Effectiveness of Dexmedetomidine vs. Propofol for ICU Sedation in Indian Teaching Hospitals

Background: Sedation is an essential component of intensive care unit (ICU) management for mechanically ventilated patients. Appropriate sedation improves patient comfort, facilitates ventilator synchrony, and reduces the risk of agitation-related complications. Among sedative agents, Dexmedetomidine and Propofol are widely used due to their rapid onset and favorable pharmacological properties. Aim: To compare the real-world effectiveness and safety of dexmedetomidine versus propofol for ICU sedation in an Indian teaching hospital. Methods: A prospective observational comparative study was conducted in the ICU of Nalanda Medical College and Hospital, Patna, India. Twenty-five mechanically ventilated adult patients requiring continuous sedation were included over a 9-month period (March 2025–December 2025). Patients received either dexmedetomidine (n=13) or propofol (n=12). Sedation quality, hemodynamic parameters, duration of mechanical ventilation, ICU stay, and adverse effects were analyzed statistically. Results: Dexmedetomidine achieved significantly better sedation stability and shorter mechanical ventilation duration compared with propofol (p<0.05). ICU length of stay was also shorter in the dexmedetomidine group. Bradycardia was observed more frequently in patients receiving dexmedetomidine. Conclusion: Dexmedetomidine provided improved sedation quality and better clinical outcomes compared with propofol for ICU sedation.