Isoflurane compared with midazolam for sedation in the intensive care unit.
OBJECTIVE
To compare isoflurane with midazolam for sedation of ventilated patients.


METHODS
Randomised control study. Setting--Intensive care unit in university teaching hospital.


METHODS
Sixty patients aged 18-76 who required mechanical ventilation.


METHODS
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).


METHODS
Achievement of a predetermined level of sedation for as much of the time as possible.


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.


CONCLUSIONS
Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit.
Kong
K L
KL
Sir Humphry Davy Department of Anesthesia, Bristol Royal Infirmary.
Willatts
S M
SM
Prys-Roberts
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D003422:Critical Care; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives; D007362:Intensive Care Units; D007530:Isoflurane / Q000494:pharmacology*; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D008875:Middle Aged; D011897:Random Allocation; D012121:Respiration, Artificial; D013997:Time Factors; D015300:Ventilator Weaning
D006993:Hypnotics and Sedatives; D007530:Isoflurane; D008874:Midazolam