Isoflurane compared with midazolam for sedation in the intensive care unit
OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% i...
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| Veröffentlicht in: | BMJ 1989-05, Vol.298 (6683), p.1277-1280 |
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| creator | Kong, K. L. Willatts, S. M. Prys-Roberts, C. |
| description | OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous intravenous infusion of midazolam 0.01-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. Incremental intravenous doses of morphine 0.05 mg/kg were given for analgesia as required. The trial sedative was stopped when the patient was judged ready for weaning from ventilatory support or at 24 hours (whichever was earlier). END POINT--Achievement of a predetermined level of sedation for as much of the time as possible. MAIN RESULTS--Isoflurane produced satisfactory sedation for a greater proportion of time (86%) than midazolam (64%), and patients sedated with isoflurane recovered more rapidly from sedation. CONCLUSION--Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit. |
| doi_str_mv | 10.1136/bmj.298.6683.1277 |
| format | Article |
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L. ; Willatts, S. M. ; Prys-Roberts, C.</creator><creatorcontrib>Kong, K. L. ; Willatts, S. M. ; Prys-Roberts, C.</creatorcontrib><description>OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous intravenous infusion of midazolam 0.01-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. Incremental intravenous doses of morphine 0.05 mg/kg were given for analgesia as required. The trial sedative was stopped when the patient was judged ready for weaning from ventilatory support or at 24 hours (whichever was earlier). END POINT--Achievement of a predetermined level of sedation for as much of the time as possible. MAIN RESULTS--Isoflurane produced satisfactory sedation for a greater proportion of time (86%) than midazolam (64%), and patients sedated with isoflurane recovered more rapidly from sedation. CONCLUSION--Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit.</description><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.298.6683.1277</identifier><identifier>PMID: 2500195</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Adolescent ; Adult ; Aged ; Analgesia ; Anesthesia ; Artificial respiration ; Blood Pressure - drug effects ; Clinical Trials as Topic ; Critical Care ; Female ; Heart Rate - drug effects ; Humans ; Hypnotics and Sedatives ; Intensive care ; Intensive Care Units ; Intravenous administration ; Isoflurane ; Isoflurane - pharmacology ; Male ; Mechanical ventilation ; Midazolam ; Midazolam - pharmacology ; Middle Aged ; Morphine ; Random Allocation ; Research Article ; Respiration, Artificial ; Sedatives ; Statistical median ; Time Factors ; Ventilation systems ; Ventilator Weaning ; Weaning</subject><ispartof>BMJ, 1989-05, Vol.298 (6683), p.1277-1280</ispartof><rights>Copyright 1989 British Medical Journal</rights><rights>Copyright BMJ Publishing Group LTD May 13, 1989</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b585t-abe4eef66958935476f5a5ba2484d39d01a0e097c86ca8b0da2f5a184002ff2c3</citedby><cites>FETCH-LOGICAL-b585t-abe4eef66958935476f5a5ba2484d39d01a0e097c86ca8b0da2f5a184002ff2c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/29703963$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/29703963$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,780,784,803,885,27922,27923,58015,58248</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2500195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kong, K. L.</creatorcontrib><creatorcontrib>Willatts, S. M.</creatorcontrib><creatorcontrib>Prys-Roberts, C.</creatorcontrib><title>Isoflurane compared with midazolam for sedation in the intensive care unit</title><title>BMJ</title><addtitle>BMJ</addtitle><addtitle>BMJ</addtitle><description>OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous intravenous infusion of midazolam 0.01-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. Incremental intravenous doses of morphine 0.05 mg/kg were given for analgesia as required. The trial sedative was stopped when the patient was judged ready for weaning from ventilatory support or at 24 hours (whichever was earlier). END POINT--Achievement of a predetermined level of sedation for as much of the time as possible. MAIN RESULTS--Isoflurane produced satisfactory sedation for a greater proportion of time (86%) than midazolam (64%), and patients sedated with isoflurane recovered more rapidly from sedation. CONCLUSION--Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analgesia</subject><subject>Anesthesia</subject><subject>Artificial respiration</subject><subject>Blood Pressure - drug effects</subject><subject>Clinical Trials as Topic</subject><subject>Critical Care</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Hypnotics and Sedatives</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Intravenous administration</subject><subject>Isoflurane</subject><subject>Isoflurane - pharmacology</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Midazolam</subject><subject>Midazolam - pharmacology</subject><subject>Middle Aged</subject><subject>Morphine</subject><subject>Random Allocation</subject><subject>Research Article</subject><subject>Respiration, Artificial</subject><subject>Sedatives</subject><subject>Statistical median</subject><subject>Time Factors</subject><subject>Ventilation systems</subject><subject>Ventilator Weaning</subject><subject>Weaning</subject><issn>0959-8138</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkUuLFDEUhYMoYzPOD3AhFAiurDapvDeC0zgPGcfNqODmkqpK2WmrKm2SGkd_vWm66VZBcXUX5zuXc-9B6DHBc0KoeFEPq3ml1VwIReekkvIemhEmVMkVpffRDGuuS0WoeohOYlxhjCsqlRb8CB1VHGOi-Qy9uYy-66dgRls0flibYNvim0vLYnCt-eF7MxSdD0W0rUnOj4Ubi7S0eSQ7RnebXdlSTKNLj9CDzvTRnuzmMXp_9vpmcVFevTu_XLy6KmuueCpNbZm1nRCaK005k6LjhtemYoq1VLeYGGyxlo0SjVE1bk2VAaJYzt91VUOP0cvt3vVUD7Zt7JiC6WEd3GDCd_DGwe_K6Jbw2d8CUVRwSvKCZ7sFwX-dbEwwuNjYvs9P8FMEqXGmqM7g0z_AlZ_CmI8DSpjkVGvM_kURKQUj-eU4U2RLNcHHGGy3D0wwbPqE3CfkPmHTJ2z6zJ4nv166d-zaO-irmHw4yFpiqgXNernVXUz2bq-b8AWEpJLD9YcFLM6ub96efvoIF5l_vuU3Uf4nXnnADzf_lf8JGBXQPg</recordid><startdate>19890513</startdate><enddate>19890513</enddate><creator>Kong, K. 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L.</au><au>Willatts, S. M.</au><au>Prys-Roberts, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Isoflurane compared with midazolam for sedation in the intensive care unit</atitle><jtitle>BMJ</jtitle><stitle>BMJ</stitle><addtitle>BMJ</addtitle><date>1989-05-13</date><risdate>1989</risdate><volume>298</volume><issue>6683</issue><spage>1277</spage><epage>1280</epage><pages>1277-1280</pages><issn>0959-8138</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><abstract>OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous intravenous infusion of midazolam 0.01-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. Incremental intravenous doses of morphine 0.05 mg/kg were given for analgesia as required. The trial sedative was stopped when the patient was judged ready for weaning from ventilatory support or at 24 hours (whichever was earlier). END POINT--Achievement of a predetermined level of sedation for as much of the time as possible. MAIN RESULTS--Isoflurane produced satisfactory sedation for a greater proportion of time (86%) than midazolam (64%), and patients sedated with isoflurane recovered more rapidly from sedation. CONCLUSION--Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>2500195</pmid><doi>10.1136/bmj.298.6683.1277</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0959-8138 |
| ispartof | BMJ, 1989-05, Vol.298 (6683), p.1277-1280 |
| issn | 0959-8138 1468-5833 1756-1833 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1836531 |
| source | MEDLINE; JSTOR Archive Collection A-Z Listing; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Analgesia Anesthesia Artificial respiration Blood Pressure - drug effects Clinical Trials as Topic Critical Care Female Heart Rate - drug effects Humans Hypnotics and Sedatives Intensive care Intensive Care Units Intravenous administration Isoflurane Isoflurane - pharmacology Male Mechanical ventilation Midazolam Midazolam - pharmacology Middle Aged Morphine Random Allocation Research Article Respiration, Artificial Sedatives Statistical median Time Factors Ventilation systems Ventilator Weaning Weaning |
| title | Isoflurane compared with midazolam for sedation in the intensive care unit |
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