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PubMed · 7619374

Optimizing sedation in critically ill, mechanically ventilated patients.

K S Bizek
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Abstract

Patients on mechanical ventilators may experience discomfort, fear, anxiety, and pain. Sedative and adjunctive medications often are prescribed on an "as needed" basis. This article reviews current trends in sedation administration and suggests strategies for optimizing sedation management. Pharmacologic properties of commonly used medications are presented.

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K S Bizek. 1995. Optimizing sedation in critically ill, mechanically ventilated patients.. https://pubmed.ncbi.nlm.nih.gov/7619374/

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PubMed2006

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BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.

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