Background: State of the art sedation concepts on intensive care units (ICU) favor propofol for a time period of up to 72 h and midazolam for long-term sedation. However, intravenous sedation is associated with complications such as development of tolerance, insufficient sedation quality, gastrointestinal paralysis, and withdrawal symptoms including cognitive deficits. Therefore, we aimed to investigate whether sevoflurane as a volatile anesthetic technically implemented by the anesthetic-conserving device (ACD) may provide advantages regarding 'weaning time', efficiency, and patient's safety when compared to standard intravenous sedation employing propofol.
Method/design: This currently ongoing trial is designed as a two-armed, monocentric, randomized prospective phase II study including intubated intensive care patients with an expected necessity for sedation exceeding 48 h. Patients are randomly assigned to either receive intravenous sedation with propofol or sevoflurane employing the ACD. Primary endpoint is the comparison of the 'weaning time' defined as the time required from discontinuation of the sedating agent until sufficient spontaneous breathing occurs. Moreover, sedation depth evaluated by Richmond Agitation Sedation Scale and parameters of patient's safety (that is, vital signs, laboratory monitoring of organ function) as well as the duration of mechanical ventilation and overall stay on the ICU are analyzed and compared. An intention-to-treat analysis will be carried out with all patients for whom it will be possible to define a wake-up time. In addition, a per-protocol analysis is envisaged. Completion of patient recruitment is expected by the end of 2012.
Discussion: This clinical study is designed to evaluate the impact of sevoflurane during long-term sedation of critically ill patients on 'weaning time', efficiency, and patient's safety compared to the standard intravenous sedation concept employing propofol.
Trial Registration: EudraCT2007-006087-30; ISRCTN90609144.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502585 | PMC |
| http://dx.doi.org/10.1186/1745-6215-13-135 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Abuse potential and analgesic efficacy of intravenous hydromorphone bolus administration among hospitalized patients with cancer pain: A double-blind, double dummy, randomized crossover trial.
Cancer
February 2025
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.
Background: There is much concern that opioids administered as intravenous (iv) bolus for pain relief may inadvertently increase their risk for abuse. However, there is insufficient data to support this. The authors compared the abuse liability potential, analgesic efficacy, and adverse effect profile of fast (iv push) versus slow (iv piggyback) administration of iv hydromorphone among hospitalized patients requiring iv opioids for pain.
View Article and Find Full Text PDFRemifentanil-Propofol-Ketamine- Based Total Intravenous Anesthesia with Spontaneous Breathing for Adult Rigid Bronchoscopy.
J Clin Med
January 2025
Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
Rigid bronchoscopy (RB) is the gold standard for managing central airway obstruction (CAO), a life-threatening condition caused by both malignant and benign etiologies. Anesthetic management is challenging as it requires balancing deep sedation with maintaining spontaneous breathing to avoid airway collapse. There is no consensus on the optimal anesthetic approach, with options including general anesthesia with neuromuscular blockers or spontaneous assisted ventilation (SAV).
View Article and Find Full Text PDFSafety and Satisfaction Analysis of Intravenous and Inhalational Conscious Sedation in a Geriatric Population Undergoing Oral Surgery.
Healthcare (Basel)
January 2025
Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain.
: The objective of this research was to compare two methods of conscious sedation (midazolam vs. sevoflurane) used for performing oral surgical procedures in the older adult population by analyzing dental treatment-related anxiety levels, the quality of sedation, and potential hemodynamic changes during the interventions, as well as post-recovery symptoms and patient satisfaction levels. : A total of 104 patients underwent oral surgery with intravenous (age: 84.
View Article and Find Full Text PDFComparative Evaluation of Regain of Consciousness in Dexmedetomidine-Propofol versus Ketamine-Propofol in the Pediatric Cardiac Catheterization Procedure under Sedation using BIS Monitoring: A Randomized Prospective Study.
Ann Card Anaesth
January 2025
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: Congenital heart diseases (CHDs) are not rare and often require an intervention at some point of time. Pediatric cardiac catheterization, a minimally invasive procedure, is performed to diagnose and to correct many cardiac abnormalities. Deep sedation with spontaneously breathing patients is the preferred technique for pediatric catheterization in the pediatric population.
View Article and Find Full Text PDFPharmacokinetics of remimazolam, midazolam and diazepam in sheep.
Vet Anaesth Analg
December 2024
Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA; Kenneth L. Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA.
Objective: To model pharmacokinetics of three benzodiazepines and their metabolites in sheep.
Study Design: A nonblinded, prospective, experimental study.
Animals: A group of six adult Hampshire-Suffolk cross-bred sheep (three females, three castrated males), 73 ± 3 kg (mean ± standard deviation).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!