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Emerg Med J 2004;21:632-634 doi:10.1136/emj.2003.007526
  • Case report

Propofol combined with lorazepam for severe poly substance misuse and withdrawal states in intensive care unit: a case series and review

  1. K Subramaniam,
  2. R M Gowda,
  3. K Jani,
  4. W Zewedie,
  5. R Ute
  1. Long Island College Hospital, Brooklyn, NY, USA
  1. Correspondence to:
 Dr K Subramaniam
 Beth Israel Deaconess Medical Center, Department of Anesthesia and Critical Care, 330 Brookline Avenue, Boston, 02215, USA; kathirvelsyahoo.com
  • Accepted 5 June 2003

Abstract

A safe, rapid, and effective way to detoxify patients from substance misuse is important in facilitating further treatment of their psychiatric or substance use disorder. This paper discusses the treatment of acute withdrawal from polysubstance misuse in three patients in the intensive care unit setting using combined sedation with a benzodiazepine, lorazepam, and a general anaesthetic, propofol. Lorazepam alone was not effective in massive doses in these cases. The advantages and mechanism of action of using multiple agents to control refractory symptoms is discussed.

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