Báo cáo y học: "A prospective randomised pilot study of sedation regimens in a general ICU population: a reality-based medicine study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: A prospective randomised pilot study of sedation regimens in a general ICU population: a reality-based medicine study. | Research paper 79 A prospective randomised pilot study of sedation regimens in a general ICU population a reality-based medicine study Simon R Finfer Anne M O Connor and Malcolm M Fisher Background For logistical reasons sedation studies are often carried out in elective surgical patients and the results extrapolated to the general intensive care unit ICU population. We question the validity of this approach. We compared the two sedation regimens used in our general ICU in a trial structured to mimic clinical practice as closely as possible. Results Forty patients were randomised to intermittent diazepam or continuous midazolam and sedation monitored with hourly sedation scores 31 patients completed the study. Scores indicating undersedation were more common with diazepam P overall adequate sedation midazolam diazepam P . No patient exhibited inappropriately prolonged sedation. Cost was midazolam AUS h diazepam AUS h. Conclusion Both regimens produced rapid onset of acceptable sedation but undersedation appeared more common with the cheaper diazepam regimen. At least 140 patients should be studied to provide evidence applicable to the general ICU population. Used alone a sedation score may be an inappropriate outcome measure for a sedation trial. Addresses Intensive Therapy Unit Royal North Shore Hospital of Sydney St Leonards NSW Australia Correspondence Dr SR Finfer MB BS MRCP FRCA FFICANZCA Senior Staff Specialist Intensive Therapy Unit Royal North Shore Hospital of Sydney St Leonards NSW 2065 Australia. Tel 02 9926 8656 fax 02 9439 8418 e-mail sfinfer@ Keywords critical care midazolam diazepam sedatives nonbarbiturate therapeutic use comparative study Received 12 June 1998 Revisions requested 28 February 1999 Revisions received 26 May 1999 Accepted 6 June 1999 Published 24 June 1999 Crit Care 1999 3 79-83 The original version of this paper is the electronic version which can be seen on the Internet http .

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