title: Is alfentanil by infusion useful for sedation on the ITU?
abstract: Methods of sedation in the ITU have changed considerably over the last few years. Whereas the use of muscle relaxants to control ventilation was a frequent feature of those ITUs reviewed by Merriman, a more recent study by Gast and colleagues revealed a far greater use of narcotics and/or hypnotics, or combinations of the two. Alfentanil has many of those ideal properties needed of a sedative drug in the ITU--its use is associated with marked cardiovascular stability, it is a potent ventilatory depressant, has a high therapeutic ratio, minimal immunological or metabolic effects, and has an appropriate kinetic profile (low liposolubility, small volume of distribution, short half-life). The present paper describes the use of an infusion of alfentanil, in combination with increments of midazolam, to provide sedation and control of ventilation in patients admitted to a general ITU.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015760:Alfentanil; D003422:Critical Care; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D007262:Infusions, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use
chemical_list: D006993:Hypnotics and Sedatives; D015760:Alfentanil; D009020:Morphine; D008874:Midazolam; D005283:Fentanyl; D006854:Hydrocortisone