A study compared the effects of propofol and midazolam infusions on cardiovascular stability in 75 critically ill patients requiring sedation in the intensive care unit at Azadi and Tikrit Teaching Hospitals from December 2024 to March 2025.

Critically ill patients commonly receive sedation for mechanical ventilation and anxiety reduction, with propofol and midazolam being frequent choices despite concerns about their differing impacts on hemodynamics. The study aimed to evaluate how these sedatives influence parameters like blood pressure and heart rate.

Results showed that propofol was associated with a higher incidence of hypotension (50%) and bradycardia (37.5%) compared to midazolam (28.6% and 14.3%, respectively), suggesting better cardiovascular stability with midazolam, which also had fewer overall adverse effects.

Conversely, propofol facilitated faster recovery, leading to shorter average ICU stays (8 days vs. 10 days with midazolam) and quicker weaning from mechanical ventilation (5 days vs. 7 days). The conclusion drawn is that while both are used, propofol may be linked to a less favorable cardiovascular profile than midazolam in this population.

The authors recommend further large-scale randomized controlled trials to definitively determine the comparative effects on cardiovascular stability in critically ill patients.

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