Dexmedetomidine Versus Midazolam Following Cesarean Section: A Randomized Blinded Trial

Background: Postoperative sedation and analgesia are of great importance in puerperas following caesarean section (CS). Objectives: The aim of this study was to compare the sedative and analgesic effects of midazolam and dexmedetomidine (DX) in patients undergoing CS. Methods: A total of 135 female patients scheduled for CS were randomly allocated into three groups using block randomization with a parallel sampling method: 0.5 µg/kg DX (n = 45), 2 mg midazolam (n = 45), and normal saline (NS) (n = 45). Medications were administered following delivery. Hemodynamic variables, level of sedation (assessed using the Ramsay sedation score), and level of analgesia (measured using the Visual Analog Scale) were recorded and compared at multiple time intervals. Results: The mean age of participants was 25.6 ± 3.9 years. The intensity of pain was significantly lower in the DX group compared to the midazolam and control groups at 3-hour, 6-hour, and 12-hour intervals (P < 0.05). However, no significant difference was observed between the midazolam and control groups (P > 0.05). Both drug groups exhibited similar levels of sedation, which were significantly higher than those in the control group (P < 0.05). Nausea and vomiting were the most commonly reported complications. Conclusions: Compared to midazolam, add-on therapy with DX was associated with superior pain control following CS. The DX and midazolam demonstrated comparable sedative effects.