Author Login

Correspondence to Author: Juliana Fontes Beltran Paschoal^1,2,3, Isabelle Pinheiro Santos²,Délio Tiago Martins Malaquias², Kátia Cilene de Freitas^2,3, Maria Eduarda Barbosa Leão^2,3, Alessandra Carvalho Silva^2,3, Kamilly Lins da Silva^2,3, Mateus Rodrigues Mazurek^2,3, Maria Júlia Ramos de Menezes^2,3, Rafael Tavares Fernandes^2,3, Maraisa dos Santos Oliveira^2,3, Leonardo Tomé da Silva^2,3, Ana Patrícia Gonçalves Araújo^2,3, Thamara Vitória Pereira^2,3, Lais Ambrosio Rocha Rita^2,3, Karolaynne Cristina de Paula^2,3, Larissa Geovana Araujo Silva ^2,3, Gabriela Mariano Borges Preto^2,3, Alessa Alawara Santos Montes^2,3, Luana Chechetto de Lima^2,3, Karina F dias^2,3, Thalita Pinheiro Morel Alineri⁴, Giovana Casarini Yamashiro⁵, Thiago Augusto Rochetti Bezerra^2,6. 

1. PhD in Biotechnology. University of São Paulo. São Paulo, Brazil.
2. Medical student. University of Ribeirão Preto. Guarujá, São Paulo, Brazil.
3. Member of LAAN - Liga Acadêmica de Anestesiologia UNAERP - Guarujá, São Paulo, Brazil.
4. Medical student. UNOESTE. Guarujá, São Paulo, Brazil.
5. Medical student. Nove de Julho University. São Bernardo do Campo, São Paulo, Brazil.
6. PhD in Medical Sciences. Ribeirão Preto Medical School, São Paulo, Brazil.

DOI: 10.52338/joa.2025.4595

Abstract:

Introduction:With the advance of intensive care medicine, sedatives have come to play a crucial role in the management of critically ill patients, especially those on mechanical ventilation. The development of agents such as dexmedetomidine has revolutionized modern medical practice. The use of sedatives is of fundamental importance in operating theatres, helping to manage anxiety, reduce stress and facilitate surgical and anaesthetic procedures. These substances are mainly used to induce conscious or unconscious sedation, depending on the complexity of the procedure and the patient’s clinical state. The use of sedatives in the elderly requires caution due to the increased risk of complications in this age group. Although there are no specific statistics from the Ministry of Health on complications arising from the use of sedatives in the elderly.
Objectives: To compare the side effects of the most commonly used sedatives in operating rooms and their influence on elderly patients; to determine the sedative drug in operating rooms with the greatest clinical safety and least functional impact on elderly patients; to analyze and compare the pros and cons of using sedatives (Midazolam, Clonidine, Dexmedetomidine, Diazepam and Droperidol) in elderly patients in operating rooms according to the literature.
Methodology: A systematic review of clinical trials and observational studies published between 2019 and 2024 was carried out.
Discussion / Conclusions: Choosing the ideal sedative for surgical procedures in elderly patients requires a careful analysis that considers the pros and cons of each pharmacological agent. This comparative study has shown that, although several drugs are effective in inducing and maintaining sedation, factors such as safety profile, impact on the cardiovascular and respiratory systems, and age-adapted pharmacokinetics are crucial to decision-making. The analysis reinforces the importance of individualized management, which takes into account the patient’s clinical condition, comorbidities and the type of procedure to be performed. Investing in training medical staff on the specifics of sedation in elderly patients and adopting evidence-based protocols are fundamental strategies for optimizing results and minimizing complications. Therefore, the choice of the ideal sedative drug should not only be based on its efficacy, but also on its safety, considering the balance between the benefits and risks associated with its use in elderly patients. The integration of personalized anesthetic practices and advances in pharmacological studies will allow for the continuous evolution of geriatric anesthesia, providing greater safety and comfort to patients in this age group.
Keywords: Elderly, geriatric, Sedation in the operating room, Effects of Midazolam, Clonidine, Dexmedetomidine, Diazepam and Droperidol in elderly patients in the operating room.

Citation:

Dr.Thiago Augusto Rochetti Bezerra, Comparative Analysis Of The Best Drug Of Choice For Sedation In A Surgical Procedure In Elderly Patients: Pros And Side Effects Of Sedatives. Journal of Anaesthesia 2025.