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.

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

“…There are differences across the world regarding choice of opioid for critically ill patients. Fentanyl and sufentanil are the opioids of choice in Germany [1,24,25]. In the four studies where the control group received morphine [26][27][28][29] the result was significantly in favor of remifentanil.…”

Mechanical Ventilation Practices of Turkish Emergency Physicians: A National Survey

“…[14] In two studies (one of which was a multinational survey conducted by Soliman et al with 647 intensive care physicians and the other conducted by O'Connor et al on sedation usage during MV) it was reported that the most frequently used sedative agents were midalozam and propofol, respectively. [15,16] In our study, the sedative most frequently used in intubated patients was midazolam, followed by diazepam in frequency of use. We also found that if two medicines were used together as sedative agents, the most frequent combination was midazolam and propofol.…”

Uma pesquisa quase experimental em enfermagem sobre dor em pacientes em coma

“…There is variability in European countries regarding the use of sedatives: midazolam and propofol are the most commonly administered drugs. As analgesic medicines, morphine and fentanyl are most commonly used (18) . Authors claim that less than half the patients receive proper pain control in ICU, which confirms the findings of this study (19) .…”