Table 3.

Advantages and disadvantages of sedative drugs in NIV^*.

Drugs	Advantages	Disadvantages
Midazolam	•Good efficacy •Hemodynamic stability	•Increased risk of delirium and paradoxical agitation •Accumulation in critically ill patients who are obese, have low albumin levels, or renal failure
Propofol	Advantageous pharmacokinetic profile	Can cause hypotension and apnea
Dexmedetomidine	•No respiratory depression •Providing sedation, anxiolysis and analgesia •Seems superior to midazolam in terms of maintaining sedation with fewer dose adjustments	•Bradycardia and hypotension •Cautiously in patients with hemodynamic instability
Remifentanil	•Metabolism not affected by hepatic or renal dysfunction •Easy to titrate to effect •No accumulation	•Chest wall rigidity •Nausea and Vomiting

^*Data from references 75–76, 83.