Articles: hypnotics-sedatives.
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Intensive Crit Care Nurs · Dec 2003
Multicenter StudyIntensive care sedation of mechanically ventilated patients: a national Swedish survey.
Sedation in critically ill patients is a complex issue and at the same time an important concept for ensuring patient comfort. The aim of this study was to review the current practice of sedation for patients on mechanical ventilation in Swedish intensive care units (ICUs). Questionnaires were sent by post to head nurses in 89 ICUs with mechanically ventilated patients. ⋯ This study indicates that local habits and personal attitudes seem to have a great impact on sedation routines. It therefore appears worthwhile for ICUs to review their practice and, if necessary, to consider implementing sedation scales and sedation guidelines. Research pertaining to potential complications and patient comfort in relation to different sedation levels as well as further validation of the efficacy of sedation scales is needed.
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J. Cardiothorac. Vasc. Anesth. · Oct 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialICU sedation after coronary artery bypass graft surgery: dexmedetomidine-based versus propofol-based sedation regimens.
To compare dexmedetomidine-based to propofol-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). ⋯ Dexmedetomidine provided safe and effective sedation for post-CABG surgical patients and significantly reduced the use of analgesics, beta-blockers, antiemetics, epinephrine, and diuretics.
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Multicenter Study Comparative Study Clinical Trial
Does the sedative agent facilitate emergency rapid sequence intubation?
To ascertain whether the sedative agent administered during neuromuscular-blocking agent-facilitated intubation (rapid sequence intubation [RSI]) influences the number of attempts and overall success at RSI. ⋯ Thiopental, methohexital, and propofol appear to facilitate RSI in emergency department patients, independent of patient characteristics or intubator training. A deeper plane of anesthesia may improve intubating conditions in emergency patients undergoing RSI by complementing incomplete muscle paralysis.
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J Intensive Care Med · Jan 2003
Randomized Controlled Trial Multicenter Study Clinical TrialThe role of the alpha2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit.
Dexmedetomidine was evaluated for sedation of 401 post-surgical patients in this double-blind, randomized, placebo-controlled, multicenter trial. Dexmedetomidine or saline was started on arrival in the intensive care unit (ICU) (1.0 mcg/kg for 10 minutes), then titrated at 0.2 to 0.7 mcg/kg/h to effect. Patients could be given propofol if necessary. ⋯ The majority of dexmedetomidine patients maintained blood pressures within normal range, without rebound. Hypertension, atelectasis, and rigors occurred more frequently in the control group, while hypotension and bradycardia occurred more frequently in the dexmedetomidine group. Preoperative cardiovascular conditions were not risk factors for dexmedetomidine patients.
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Pediatric emergency care · Dec 2002
Multicenter Study Comparative StudyRapid sequence intubation for pediatric emergency airway management.
To characterize current practice with respect to pediatric emergency airway management using a multicenter data set. ⋯ A large, prospective, multicenter observational study of pediatric EDIs was conducted at university-affiliated EDs. RSI is the method of choice for the majority of pediatric emergency intubations; it is associated with a high success rate and a low rate of serious adverse events. Pediatric intubation as practiced in academic EDs, with most initial attempts by emergency and pediatrics residents and fellows under attending physician supervision, is safe and highly successful.