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Light vs. heavy sedation during mechanical ventilation after oesophagectomy--a pilot experimental study focusing on memory.

Samuelson, K A M; Lundberg, D and Fridlund, Bengt LU (2008) In Acta Anaesthesiologica Scandinavica 52(8). p.1116-1123
Abstract
BACKGROUND: To assess and compare the feasibility and stressful memories of light vs. heavy sedation during post-operative mechanical ventilation. METHODS: Randomized clinical trial in one general intensive care unit (ICU) in a Swedish university hospital. Thirty-six adults were randomly assigned to receive either light [Motor Activity Assessment Scale (MAAS) 3-4] or heavy (MAAS 1-2) sedation with continuous i.v. infusion of propofol during post-operative invasive mechanical ventilation after oesophagectomy. The patients were interviewed at the general ward 5 days post-ICU using the ICU Memory Tool and the ICU Stressful Experience Questionnaire, and 2 months post-ICU using the Impact of Event Scale Revised. Patient data and hourly recorded... (More)
BACKGROUND: To assess and compare the feasibility and stressful memories of light vs. heavy sedation during post-operative mechanical ventilation. METHODS: Randomized clinical trial in one general intensive care unit (ICU) in a Swedish university hospital. Thirty-six adults were randomly assigned to receive either light [Motor Activity Assessment Scale (MAAS) 3-4] or heavy (MAAS 1-2) sedation with continuous i.v. infusion of propofol during post-operative invasive mechanical ventilation after oesophagectomy. The patients were interviewed at the general ward 5 days post-ICU using the ICU Memory Tool and the ICU Stressful Experience Questionnaire, and 2 months post-ICU using the Impact of Event Scale Revised. Patient data and hourly recorded MAAS values were collected after the interviews. RESULTS: Seventy-four per cent of the 139 MAAS values in the light sedation group (n=18) and 79% of the 142 in the heavy sedation group (n=18) were within the targeted levels, and the median MAAS scores were 3.0 vs. 1.25, respectively. Intention-to-treat analyses showed no significant difference in the prevalence of stressful memories between groups, including endotracheal tube discomfort, presenting wide 95% confidence intervals for the difference in outcome estimates. Excluding the patients with a prolonged ICU stay (n=3), a higher prevalence of delusional memories was found in the heavy sedation group (31% vs. 0%, P=0.04). CONCLUSIONS: This small randomized-controlled pilot study suggests that a light sedation regimen during short-term post-operative mechanical ventilation after major surgery is feasible without increasing patient discomfort. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
52
issue
8
pages
1116 - 1123
publisher
Wiley-Blackwell
external identifiers
  • pmid:18840113
  • scopus:49849099835
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2008.01702.x
language
English
LU publication?
yes
id
bf8ae4ed-078c-499d-b10a-795085a47f35 (old id 1262511)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18840113?dopt=Abstract
date added to LUP
2008-11-10 15:25:56
date last changed
2017-11-19 04:18:43
@article{bf8ae4ed-078c-499d-b10a-795085a47f35,
  abstract     = {BACKGROUND: To assess and compare the feasibility and stressful memories of light vs. heavy sedation during post-operative mechanical ventilation. METHODS: Randomized clinical trial in one general intensive care unit (ICU) in a Swedish university hospital. Thirty-six adults were randomly assigned to receive either light [Motor Activity Assessment Scale (MAAS) 3-4] or heavy (MAAS 1-2) sedation with continuous i.v. infusion of propofol during post-operative invasive mechanical ventilation after oesophagectomy. The patients were interviewed at the general ward 5 days post-ICU using the ICU Memory Tool and the ICU Stressful Experience Questionnaire, and 2 months post-ICU using the Impact of Event Scale Revised. Patient data and hourly recorded MAAS values were collected after the interviews. RESULTS: Seventy-four per cent of the 139 MAAS values in the light sedation group (n=18) and 79% of the 142 in the heavy sedation group (n=18) were within the targeted levels, and the median MAAS scores were 3.0 vs. 1.25, respectively. Intention-to-treat analyses showed no significant difference in the prevalence of stressful memories between groups, including endotracheal tube discomfort, presenting wide 95% confidence intervals for the difference in outcome estimates. Excluding the patients with a prolonged ICU stay (n=3), a higher prevalence of delusional memories was found in the heavy sedation group (31% vs. 0%, P=0.04). CONCLUSIONS: This small randomized-controlled pilot study suggests that a light sedation regimen during short-term post-operative mechanical ventilation after major surgery is feasible without increasing patient discomfort.},
  author       = {Samuelson, K A M and Lundberg, D and Fridlund, Bengt},
  issn         = {0001-5172},
  language     = {eng},
  number       = {8},
  pages        = {1116--1123},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Light vs. heavy sedation during mechanical ventilation after oesophagectomy--a pilot experimental study focusing on memory.},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2008.01702.x},
  volume       = {52},
  year         = {2008},
}