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VOLUME 21 , ISSUE 5 ( May, 2017 ) > List of Articles

RESEARCH ARTICLE

The benefit of benzodiazepine reduction: Improving sedation in surgical intensive care

Ralph Schneider, Andreas Puetz, Timon Vassiliou, Thomas Wiesmann, Ulrike Lewan, Hinnerk Wulf, Detlef K. Bartsch, Caroline Rolfes

Keywords : Analgesia, benzodiazepine, critical care, intensive care unit, midazolam, sedation

Citation Information : Schneider R, Puetz A, Vassiliou T, Wiesmann T, Lewan U, Wulf H, Bartsch DK, Rolfes C. The benefit of benzodiazepine reduction: Improving sedation in surgical intensive care. Indian J Crit Care Med 2017; 21 (5):274-280.

DOI: 10.4103/ijccm.IJCCM_67_17

License: CC BY-ND 3.0

Published Online: 01-05-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims: Sedation, as it is often required in critical care, is associated with immobilization, prolonged ventilation, and increased morbidity. Most sedation protocols are based on benzodiazepines. The presented study analyzes the benefit of benzodiazepine-free sedation. Methods: In 2008, 134 patients were treated according to a protocol using benzodiazepine and propofol (Group 1). In 2009, we introduced a new sedation strategy based on sufentanil, nonsteroidal anti-inflammatory drugs, neuroleptics, and antidepressants, which was applied in 140 consecutive patients (Group 2). Depth of sedation, duration of mechanical ventilation, duration of Intensive Care Unit, and hospital stay were analyzed. Results: Group 1 had both a longer duration of deep sedation (18.7 ± 2.5 days vs. 12.6 ± 1.85 days, P = 0.031) and a longer duration of controlled ventilation (311, 35 ± 32.69 vs. 143, 96 ± 20.76 h, P < 0.0001) than Group 2. Ventilator days were more frequent in Group 1 (653, 66 ± 98.37 h vs. 478, 89 ± 68.92 h, P = 0.128). Conclusions: The benzodiazepine-free sedation protocol has been shown to significantly reduce depth of sedation and controlled ventilation. Additional evidence is needed to ascertain reduction of ventilator days which would not only be of benefit for the patient but also for the hospital Management.


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