Postoperative sedation at hospital das clínicas, São Paulo, postoperative unit: a retrospective study.

Despite the established benefits of sedatives in postoperative ICUs, there is no agreement on the optimal sedative regimen or the best way to evaluate sedation depth. This retrospective study aimed at evaluating sedative approaches and their effects on ICU stay in our Hospital. Eighty-three continuously sedated patients were studied according to agent and doses used at the following moments: admission-start sedation (T INI), sedation (T SED), end of sedation-extubation (T EXT) and extubation-discharge (T DIS). In addition, ASA physical status and level of sedation according to Ramsay's score were registered. Data were submitted to ANOVA. Only patients receiving fentanyl were evaluated (N=80). From these, 34 have received another sedative. T INI was 123.4 +/- 369, T SED was 852.5 +/- 1242.3, T EXT was 241.1 +/- 156.6 and T DIS was 1433 +/- 1734.4 minutes. There were no differences on sedation doses versus ASA status (p = 0.11). Nevertheless, T DIS was higher in more critically ill patients (p < 0.001). Diastolic pressure and Ramsay score increased during sedation (p < 0.001 and 0.028, respectively). Fentanyl, complemented or not by other agents, was adequate for sedation and hemodynamic stability during postoperative intensive care.