Isoflurane for prolonged sedation in the intensive care unit ; efficacy and safety

To compare isoflurane with midazolam for prolonged sedation in ventilated patients. Randomised controlled study. General intensive care unit in university teaching hospital. Sixty patients aged 17-80 years who required mechanical ventilation for more than 24 h. Sedation with either 0.1-0.6% isoflura...

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Bibliographic Details
Published in:Intensive care medicine 1992-07, Vol.18 (7), p.415-421
Main Authors: SPENCER, E. M, WILLATTS, S. M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Critical Illness
Drug Monitoring
England
Female
Hemodynamics - drug effects
Hospitals, University
Humans
Hydrocortisone - blood
Intensive Care Units
Isoflurane - blood
Isoflurane - pharmacology
Isoflurane - therapeutic use
Male
Medical sciences
Midazolam - blood
Midazolam - pharmacology
Midazolam - therapeutic use
Middle Aged
Monitoring, Physiologic
Neuropharmacology
Pain - blood
Pain - drug therapy
Pain - physiopathology
Pharmacology. Drug treatments
Respiration, Artificial - adverse effects
Severity of Illness Index
Survival Rate
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Summary:To compare isoflurane with midazolam for prolonged sedation in ventilated patients. Randomised controlled study. General intensive care unit in university teaching hospital. Sixty patients aged 17-80 years who required mechanical ventilation for more than 24 h. Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous infusion of midazolam 0.02-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. The trial sedative was stopped when the patient was ready for weaning from ventilatory support. Measurements were made of haemodynamic, respiratory and biochemical variables regularly during the period of sedation and for a week after stopping the sedative agent. There was no difference in any of the physiological or biochemical variables recorded between the two groups. Patients sedated with isoflurane recovered more rapidly and were weaned from mechanical ventilation sooner than those sedated with midazolam. Isoflurane is a useful agent for prolonged sedation of ventilated patients and does not have any adverse effect on the cardiorespiratory system or on hepatic, renal or adrenal function.
ISSN:0342-4642
1432-1238
DOI:10.1007/BF01694344