Anest. intenziv. Med. 2009;20(3):132-136

Analgosedation in Intensive Care Units (ICU) in the Czech Republic - the results of questionnaire studyIntensive Care Medicine - Original Paper

Černý Vladimír^1,*, Pařízková Renata¹, Herold Ivan², Šrámek Vladimír³, Novák Ivan⁴, Vítková Karolína¹

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové

² Anesteziologicko-resuscitační oddělení, Klaudiánova nemocnice, Oblastní nemocnice Mladá Boleslav, a. s.

³ Anesteziologicko-resuscitační klinika, Masarykova Univerzita, Fakultní nemocnice u sv. Anny v Brně

⁴ Interní klinika, Univerzita Karlova v Praze, Lékařská fakulta v Plzni, Fakultní nemocnice Plzeň

Objective:
Study aiming to obtain information on analgosedation regimen on various types of ICUs in the Czech Republic and compare them with data published in similar foreign studies.


Design of the study:
Observational-questionnaire study.


Setting:
Various types of ICU.

Material and methods:
Two-part questionnaire was mailed to members of Intensive Care Medicine Section of CSARIM. The first part of the questionnaire covered use of analgosedation regimens in general, the second part focused in details on protocol sedation used in individual patients treated in ICU during one-day prevalence study (4. 4. 2007).

Results:
Thirty eight ICUs took part in the study. The written analgosedation regimen protocol was used in 7 (19%) of ICUs, protocol for sedation level assessment in 14 ICUs (37%). Use of NMBA (neuromuscular blocking agents) was part of the protocol in 1 ICU, daily sedation breaks was used in 8 ICUs (21%). The most frequently mentioned drugs for sedation were midazolam (in 92% ICUs drug of the first choice) and propofol (in 60% ICUs the second choice), among less frequently used drugs were diazepam, clonidin, tiapride and ketamin, use dexmedetomidin was mentioned in 9 ICUs (23%). The most often used opioids of the first choice were sufentanil (in 76%) and fentanyl (13%), among the opioids of the second choice morphine (52% ICUs) and fentanyl (21%).

Conclusion:
The most commonly used drugs for sedation are midazolam and propofol, for analgesia sufentanil and morphin. Of neuroleptics, tiapride and haloperidol are the most frequently used drugs. Neuromuscular blocking agents are used only rarely. Majority of ICUs participated in questionnaire study do not adhere to specific analgosedation protocol or routine use of sedation level scoring system.

Keywords: analgesia; sedation

Received: February 10, 2009; Accepted: March 10, 2009; Published: June 1, 2009  Show citation