[Analgesia and sedation in neurosurgical intensive care patients].
Different concepts for analgosedation of neurosurgical patients are recommended during postoperative ventilation. In 30 neurosurgical patients (2 groups of 15 patients), we studied a continuous i.v. application of alfentanil (Rapifen) and midazolam (Dormicum) compared to an application of continuously given alfentanil with discontinuously given midazolam. A good analgosedation (i.e. sufficient sedation with good neurological judgement) was more frequently achieved (8/15 patients) by continuous application of both substances (alfentanil 0.023 mg/kg b.w./h, midazolam 0.10 mg/kg b.w./h), compared to discontinuous application of midazolam (4.5/15 patients; alfentanil 0.028 mg/kg b.w./h, midazolam 0.13 mg/kg b.w./h). No differences in extubation times were observed. We conclude from our results that a continuous application of both substances is superior to a discontinuous application of midazolam with continuously given alfentanil. A lower dosage of each substance is necessary to maintain a better state of analgosedation.
Hundt
F
F
Klinik für Anästhesiologie Johannes Gutenberg-Universität Mainz.
el Gindi
M
M
Brandt
L
L
D015760:Alfentanil / Q000008:administration & dosage*; D001143:Arousal / Q000187:drug effects*; D001927:Brain Diseases / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003422:Critical Care; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000517:prevention & control*; D012121:Respiration, Artificial
D015760:Alfentanil; D008874:Midazolam
Analgosedierung bei neurochirurgischen Intensivpatienten.