Abstract
IntroductionSedation and analgesia are provided by using different agents and techniques in different countries. The goal is to achieve early spontaneous breathing and to obtain an awake and cooperative pain-free patient. It was the aim of this study to conduct a survey of the agents and techniques used for analgesia and sedation in intensive care units in Germany.MethodsA survey was sent by mail to 261 hospitals in Germany. The anesthesiologists running the intensive care unit were asked to fill in the structured questionnaire about their use of sedation and analgesia.ResultsA total of 220 (84%) questionnaires were completed and returned. The RAMSAY sedation scale was used in 8% of the hospitals. A written policy was available in 21% of hospitals. For short-term sedation in most hospitals, propofol was used in combination with sufentanil or fentanyl. For long-term sedation, midazolam/fentanyl was preferred. Clonidine was a common part of up to two-thirds of the regimens. Epidural analgesia was used in up to 68%. Neuromuscular blocking agents were no longer used.ConclusionIn contrast to the US 'Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult', our survey showed that in Germany different agents, and frequently neuroaxial techniques, were used.
Highlights
Sedation and analgesia are provided by using different agents and techniques in different countries
Lorazepam was not Clonidine as an adjuvant for sedation was used in our survey in a high percentage in all phases, whereas haloperidol, which is recommended in the American guidelines, was not a selectable option in our questionnaire
The analysis showed that for short-term sedation agents were used that had a long context-sensitive half-time [35]
Summary
Sedation and analgesia are provided by using different agents and techniques in different countries. The goal is to achieve early spontaneous breathing and to obtain an awake and cooperative pain-free patient. It was the aim of this study to conduct a survey of the agents and techniques used for analgesia and sedation in intensive care units in Germany. The anesthesiologists running the intensive care unit were asked to fill in the structured questionnaire about their use of sedation and analgesia. For shortterm sedation in most hospitals, propofol was used in combination with sufentanil or fentanyl. Neuromuscular blocking agents were no longer used Critical care therapies such as ventilation, invasive procedures or other measures inducing pain or stress require analgesia and sedation of the patient. The requirements for ideal analgesia and sedation are the ability to sedate the patient deeply for necessary procedures, but with medication of short duration so that the patient can be quickly responsive and cooperative [11].
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