Sedation

What is sedation?

Sedation is a general term that refers to the “calming of an ICU patient with the use of medications.”

Why is sedation used?

Due to a critical illness or injury, an ICU patient may experience unpleasant feelings, anxiety, agitation, fear or pain. In addition, some of the procedures and supportive care, such as mechanical ventilation, may make a patient feel uncomfortable. The ICU staff will attempt to comfort patients by speaking to them and by reassuring them. Often these efforts are not enough to comfort patients and sedation is required.

How is sedation given?

There are many different medications used for sedation. The selection of a specific medication for a patient depends upon many factors that the doctor must consider. Once selected, the medication may be given to a patient orally, intravenously (IV) or intramuscularly (IM). Some medications are given only as needed and others are given continuously.

Can sedation worsen a patient’s agitation?

This is a very common question. Many ICU patients receive sedation because they are agitated. Rarely, patients may have worsening agitation with certain medications used for sedation. This is called a paradoxical reaction to the medication. Stopping the medication or switching to a different medication usually helps.

How long is sedation used?

Sedation is used as long as the patient remains uncomfortable, agitated, anxious, fearful, or in pain. The ICU staff will regularly decrease the medication to see if the patient still needs it.

Are there any potential complications associated with the use of sedation?

Each specific medication used for sedation has its own set of side effects and complications. In general, the two most common complications of the sedative medications are decreased breathing and decreased blood pressure. The ICU staff will monitor a patient’s breathing and blood pressure during sedation. Many sedative medications cause temporary amnesia and the patient may not clearly remember the events during the period of sedation. If sedation is needed for a long period of time, the patient’s body may get use to it. The sedation will need to be decreased slowly in these patients to avoid withdrawal symptoms.