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CompletedNCT00479661ProdexUpdated Aug 13, 2010

Dexmedetomidine Versus Propofol for Continuous Sedation in the Intensive Care Unit (ICU)

A Phase 3 interventional study of Dexmedetomidine and Propofol in Continuous Sedation in Initially Sedated Adults in ICU, sponsored by Orion Corporation, Orion Pharma. Completed at 40 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2010-08-13.

Sponsored by Orion Corporation, Orion Pharma · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
500
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Patients in the ICU who need help with their breathing are put onto a machine called a ventilator and are also given a medicine, called a sedative, which helps them to sleep and makes them more comfortable. Propofol is a sedative that is routinely used for these purposes.

For most patients the aim of sedation is to make them sleepy but still able to respond to nursing staff (light sedation).

Dexmedetomidine is a new sedative for use in intensive care and in this clinical study,dexmedetomidine is compared to propofol. It is thought that dexmedetomidine might be slightly better at allowing patients to be sleepy but still respond to people around them. It also does not appear to affect patient's breathing. The purpose of this study is to test whether dexmedetomidine really does have these advantages compared to propofol.

In this study, we hope to show that: dexmedetomidine is at least as good as propofol in helping patients to sleep better and making them more comfortable, and that they are able to communicate and cooperate better with the staff treating them, and that patients treated with dexmedetomidine require a shorter time on the ventilator than those treated with propofol.

Read the detailed description

This is a phase III, multi-centre, prospective, randomised, double-blind, double-dummy, active comparator study. The study consists of three periods: screening, double-dummy treatment and follow-up period.

All patients admitted to ICU will be pre-screened according to inclusion and exclusion criteria prior to informed consent using available clinical data.

Informed consent, screening and randomisation procedures should be completed within 72 hours from the time of admission to ICU and within 48 hours from starting continuous sedation. Eligible study subjects requiring light to moderate sedation (Richmond Agitation-Sedation Scale [RASS] = 0 to -3) will be randomised to either continue on propofol or switch to dexmedetomidine. Patients should not have received any other continuously or regularly administered sedative agent than propofol during the last 12 hours except for opioid analgesics. Study treatments will be titrated to achieve an individually targeted sedation range determined on a daily basis. Rescue treatment (i.e. midazolam boli) may be given if needed to achieve the target depth of sedation. Continued need for sedation will be assessed at a daily sedation stop, conducted at the same time each day. First sedation stop may be 12-36 hours from randomisation, depending on the time of day the study subject is randomised. The duration of study treatment is limited to a maximum of 14 days from randomisation. Following withdrawal of sedation, study subjects will be monitored for 48 hours and contacted by telephone 31 and 45 days after randomisation.

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Conditions studied

  • Continuous Sedation in Initially Sedated Adults in ICU

Keywords

  • initial sedation
  • mechanical ventilation
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In context

Lead sponsor

Orion Corporation, Orion Pharma is the lead sponsor of 100 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age more than 18 years
  • Clinical need for sedation of an initially intubated (or tracheotomised) and ventilated (with inspiratory assistance) patient
  • Prescribed light to moderate sedation (target RASS = 0 to -3) using propofol
  • Patients should be randomised within 72 hours from ICU admission and within 48 hours of commencing continuous sedation in the ICU
  • Patients should have an expected requirement for sedation more than 24 hours from time of randomisation
  • Written informed consent must be obtained according to local regulations before starting any study procedures other than pre-screening

Exclusion criteria

Exclusion Criteria:

  • Acute severe intracranial or spinal neurological disorder due to vascular causes, infection, intracranial expansion or injury
  • Uncompensated acute circulatory failure at time of randomisation (severe hypotension with mean arterial pressure [MAP] \< 55 mmHg despite volume and pressors)
  • Severe bradycardia (heart rate [HR] \< 50 beats/min)
  • AV-conduction block II-III (unless pacemaker installed)
  • Severe hepatic impairment (bilirubin > 101 µmol/l)
  • Need for muscle relaxation at the time of randomisation (may only be used for intubation and initial stabilization)
  • Loss of hearing or vision, or any other condition which would significantly interfere with the collection of study data
  • Burn injuries requiring regular anaesthesia or surgery
  • Use of centrally acting α2 agonists or antagonists at the time of randomisation, notably clonidine
  • Patients who have or are expected to have treatment withdrawn or withheld due to poor prognosis
  • Patients receiving sedation for therapeutic indications rather than to tolerate the ventilator (e.g. epilepsy)
  • Patients who are unlikely to require continuous sedation during mechanical ventilation (e.g. Guillain-Barré syndrome)
  • Patients who are unlikely to be weaned from mechanical ventilation e.g. diseases/injuries primarily affecting the neuromuscular function of the respiratory apparatus such as clearly irreversible disease requiring prolonged ventilatory support (e.g. high spinal cord injury or advanced amyotrophic lateral sclerosis)
  • Distal paraplegia
  • Positive pregnancy test or currently lactating
  • Received any investigational drug within the preceding 30 days
  • Concurrent participation in any other interventional study (any study in which patients are allocated to different treatment groups and/or non-routine diagnostic or monitoring procedures are performed)
  • Previous participation in this study
  • Any other condition which, in the investigator's opinion, would make it detrimental for the subject to participate in the study
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
500 participants (actual)

Study arms

  • Experimental
    1

    Dexmedetomidine

    Drug: Dexmedetomidine

  • Active comparator
    2

    Propofol

    Drug: Propofol

Interventions

  • DrugDexmedetomidine

    Continuous infusion

  • DrugPropofol

    Continuous infusion

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What researchers measure

Primary outcomes

  1. Depth of sedation using the RASS. The target RASS range (target depth of sedation) should be 0 to -3 for a patient to be included in the study. The target may be amended during the study treatment, if clinically required.

    Time frame: 2 hourly and before each rescue treatment dose during the treatment period and the 48-hour follow-up

  2. Duration of mechanical ventilation

    Time frame: Start and stop times of mechanical ventilation while the patient is treated in the ICU

Secondary outcomes

  1. Nurse's assessment of subject communication with visual analogue scales (VAS)

    Time frame: At the end of each nursing shift during study treatment and 48 h follow-up period in the ICU

  2. Length of ICU stay

    Time frame: Admission and discharge dates and times during the current ICU treatment period

07

Study locations

40 sites
  • Onze-Lieve-Vrouw Ziekenhuis, Anesthesia and Intensive Care Dept. Moorselbaan 164
    Aalst, 9300, Belgium
  • Ziekenhuis Oost-Limburg Location Sint-Jan, Dept.of Anesthesiology, Schiepse Bos
    Genk, 3600, Belgium
  • HUCH, Jorvi Hospital, Turuntie 150,
    Espoo, 02740, Finland
  • HUCH, Meilahti Hospital, Haartmaninkatu 4, P.O.Box 340,
    Helsinki, 00029, Finland
  • North Carelia Central Hospital, Tikkamaentie 16,
    Joensuu, 80210, Finland
  • Kuopio University Hospital
    Kuopio, 70210, Finland
  • Paijat-Hame Central Hospital, Keskussairaalankatu 7,
    Lahti, 15850, Finland
  • South Carelia Central Hospital, Valto Kakelan katu 1,
    Lappeenranta, 53130, Finland
  • Seinajoki Central Hospital, Hanneksenrinne 7,
    Seinajoki, 60220, Finland
  • Tampere University Hospital, ICU, Teiskonntie 35, P.O.Box 2000,
    Tampere, 33521, Finland
  • Charite Berlin Klinik fur Anasthesiologie und Operative Intensivmedizin (CCM), Luisenstrasse 65 (LU 65),
    Berlin, 10117, Germany
  • Universitatsklinikum Bonn, Klinik u. Poliklinik f. Anasthesiologie u.
    Bonn, 53105, Germany
  • Universitatsklinikum, Krankenhausstrsse 12,
    Erlangen, 91054, Germany
  • Klinikum der Johann-Wolfgang-Goethe Universitat, Klinik fur Anasthesiologie,
    Frankfurt am Main, 60590, Germany
  • Univ. Giessen und Marburg Abt. Anaesthesiologie, Intensivmedizin, Schmerztherapie & Palliativmedizin, Rudolf-Buchheim-Strasse 7,
    Giessen, 35392, Germany
  • Universitatsklinikum Halle, Universitatsklinik fur Anasthelsiologie und Operative Intensivmedizin, Ernst-Grube Strasse 40
    Halle, 06097, Germany
  • Universitatsklinikum Heidelberg Klinik fur Anasthesiologie, Im Neuenheimer Feld 110,
    Heidelberg, 69120, Germany
  • Klinik fur Anasthesiologie, Intensivmedizin und Schmerztherapie, Universitatsklinikum des Saarlandes, Gebaude 57,
    Homburg, 66421, Germany
  • Universitatsklinikum Leipzig, Klinik und Poliklinik fur Anaesthesiologie und Intensivtherapie, Liebigstrasse 29
    Leipzig, 04103, Germany
  • Klinikum St. Georg, Delitzscher Strasse 141, Hause 20, 1. Etage, Zimmer 204
    Leipzig, 04129, Germany
  • Universitatsklinikum Tubingen, Klinik fur Anasthesiologie und Intensivmedizin
    Tubingen, 72076, Germany
  • Klinikum-Wetzlar-Braunfels, Forsthaus Strasse 1-3a
    Wetzlar, 35578, Germany
  • Jeroen Bosch Ziekenhuis, Postbus 90153,
    Hertogenbosch, 5200 ME, Netherlands
  • Westfries Gasthuis, Department Intensieve Zorgen, Maelsonstraat 3,
    Hoorn, 1624 NP, Netherlands
  • Rivierenland Hospital, Pres. Kennedylaan 1,
    Tiel, 4001 WP, Netherlands
  • Kemerovo Stte Medical Academy, 22/A Voroshilov Street
    Kemerovo, 650026, Russian Federation
  • Municipal Hospital #2, Krasnodar Diversified Treatment and Diagnostic Association, 6, Ulica Krasnykh Partizan Building 2,
    Krasnodar, 350012, Russian Federation
  • Federal State Institution Russian Centre of Functional Surgical Gastroenterology, Krasnodor Municipal Hospital, 4, ulica Sedina,
    Krasnodar, 350086, Russian Federation
  • State Institution B.B. Petrovsky Russian Research Centre of Surgery of RAMS, 2, Abrikosovsky per.
    Moscow, 119992, Russian Federation
  • State Healthcare Institution V.A. Baranov Republican Hospital, 3, Pirogova Ulica,
    Petrozavodsk, 185019, Russian Federation
  • Federal State Healthcare Institution L.G. Sokolov Clinical Hospital, #122 of FMBA of Russia, 4, pr-t Kultury
    St .Petersburg, 194291, Russian Federation
  • Medical Academy of Postgraduate Study, 41, ulica Kirochnaya,
    St. Petersburg, 191015, Russian Federation
  • Inselspital, Freiburgstsrasse 4,
    Bern, CH-3010, Switzerland
  • West Suffolk Hospital NHS Trust, Hardwick Lane, Suffolk,
    Bury Saint Edmunds, IP33 2QZ, United Kingdom
  • Edinburgh University, Little France Crescent, Edinburgh Royal Infirmary,
    Edinburgh, EH16 2SA, United Kingdom
  • Leeds General Infirmary, Great George Street
    Leeds, LS1 3EX, United Kingdom
  • Saint John's Hospital, Howden Road West,
    Livingston, EH54 6PP, United Kingdom
  • Saint Thomas Hospital, Lambeth Palace Road,
    London, SE1 7EH, United Kingdom
  • Saint George's Hospital, Blackshaw Road, Tooting
    London, SW17 0QT, United Kingdom
  • Freeman Hospital, Freeman Road High Heaton,Newcastle Upon Tyne
    Tyne and Wear, NE7 7DN, United Kingdom
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References and documents

Publications

  • Turunen H, Jakob SM, Ruokonen E, Kaukonen KM, Sarapohja T, Apajasalo M, Takala J. Dexmedetomidine versus standard care sedation with propofol or midazolam in intensive care: an economic evaluation. Crit Care. 2015 Feb 19;19(1):67. doi: 10.1186/s13054-015-0787-y. PubMed 25887576 ↗
  • Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J; Dexmedetomidine for Long-Term Sedation Investigators. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA. 2012 Mar 21;307(11):1151-60. doi: 10.1001/jama.2012.304. PubMed 22436955 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 13, 2010, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00479661
Lead sponsor
Orion Corporation, Orion Pharma
First posted
May 28, 2007
Start date
May 2007
Primary completion
Mar 2010
Completion
Mar 2010
Last update
Aug 13, 2010

Study contacts

Esko Ruokonen, MD
principal investigator · Kuopio University Hospital
Kati Kaijasilta, MSc (Pharm)
study director · Orion Corporation, Orion Pharma

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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