Chest
Propofol vs Midazolam in Short-, Medium-, and Long-term Sedation of Critically III Patients: A Cost-Benefit Analysis
Section snippets
Patients
In a prospective study, patients admitted to our general 14-bed ICU were randomized to groups between January and September 1991. Criteria for admission to the study were (1) age above 16 years old, (2) probable need for controlled mechanical ventilation, and (3) severity of illness classified at admission as equal to or higher than 9 points on the simplified acute physiologic score (SAPS).10 Informed consent was obtained either directly from the patient or from his or her relatives. One
Group Comparison
Eighty-eight patients were admitted to the study. Forty-six patients (40 men and 6 women) received propofol, and 42 (36 men and 6 women) were sedated with midazolam.
There were no significant differences between groups and subgroups with respect to age, weight, consciousness level before starting sedation (valued by GCSC scoring), and severity of illness at admission (determined by SAPS scoring) (Table 1).
Reasons for Admission: A wide variety of illnesses motivated admission. In the
DISCUSSION
Elimination of etomidate and the alfaxalone-alfadolone combination (Althesin) has produced difficulties in the search for an ideal sedative agent in intensive care practice. Because of their cumulative side effects, thiopental (thiopentone) and other barbiturates are not advisable for continuous perfusion. Although clomethiazole promised to be useful, its use should be accompanied by a provision of fluids, and recovery delays of up to 48 h have been reported.13 Ketamine offers the advantage of
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Anaesthesia
Cited by (0)
Supported by the Hospital de Barcelona Research Committee.
NOTE: The current (1/93) exchange rate is 111 pesetas to $1 US.
Manuscript received March 1!; revision accepted June 23.