Abstract
Sedation is one of the commonest therapies that we use in intensive care. An international survey of 3,500 patients in 2005 showed that 68% of patients who were ventilated for more than 12 hours received sedation at some time during their stay in intensive care. Although we prescribe sedation on a daily basis, we do not always do so well, or give it the attention it deserves. It is only over the last ten years that we have begun to be aware of the importance of sedation and its impact on the way we care for our patients. We are more aware of the potential harm resulting from the way in which we sedate patients and the drugs that we use. Hopefully we have moved away from the scenario Thomas Petty described in 1998, “I am troubled today when I make rounds in critical care…., but what I see these days are paralysed, sedated patients lying without motion appearing to be dead.” Patients today are more likely to be awake and comfortable on a ventilator. We have begun to investigate the consequences of over sedation, such as delirium and post traumatic stress disorder. There is still a long way to go however, before we can say that we have implemented the current evidence base into our daily clinical practice.
The three articles on sedation in this edition of JICS are based on talks given at a one day ICS Symposium in July of this year which was sponsored by GSK who have also supported the publication of these articles. The feedback from the seminar was very positive and shows there is a real interest in the subject. We hope to repeat the seminar next year to coincide with the publication of the ICS guidelines on sedation and analgesia.