title: Sedative and analgesic practice in the intensive care unit: the results of a European survey.
abstract: Sedation and analgesia are important aspects of patient care on the intensive care unit (ICU), yet relatively little information is available on common sedative and analgesic practice. We sought to assess international differences in the prescription of sedative and analgesic drugs in western European ICUs by means of a short, self-administered questionnaire. Six hundred and forty-seven intensive care physicians from 16 western European countries replied to the questionnaire. Midazolam was used as a sedative often or always by 63% of respondents and propofol by 35%. There were considerable international variations, with midazolam being preferred over propofol in France, Germany, the Netherlands, Norway and Austria. For analgesia, the drugs most commonly used were morphine (33%), fentanyl (33%) and sufentanil (24%). Morphine was preferred over fentanyl and sufentanil in Norway, UK and Ireland, Sweden, Switzerland, the Netherlands, and Spain and Portugal. Fentanyl was preferred in France, Germany and Italy. Sufentanil was preferred in Belgium and Luxemburg and in Austria. Multivariate analysis showed that the combination of midazolam with fentanyl was most often used in France; propofol with morphine in Sweden, the UK and Ireland, and Switzerland; midazolam with morphine in Norway; and propofol with sufentanil in Belgium and Luxemburg, Germany and Italy. The use of a sedation scale varied from 72% in the UK and Ireland to 18% in Austria. When used, the most common sedation scale was the Ramsay scale. This study demonstrates substantial international differences in sedative and analgesic practices in western European ICUs.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Route de Lennik 808, B-1070 Brussels, Belgium.
authors.forename: H M
authors.initials: HM
authors.lastname: Soliman
authors.forename: C
authors.initials: C
authors.lastname: Mélot
authors.forename: J L
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D003195:Computer Communication Networks; D016292:Procedural Sedation / Q000379:methods*; D003422:Critical Care / Q000379:methods*; D005060:Europe; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D008874:Midazolam / Q000008:administration & dosage; D010818:Practice Patterns, Physicians'; D015742:Propofol / Q000008:administration & dosage; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D008874:Midazolam; D015742:Propofol