CITATION Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J; Dexmedeto midine for Long-Term Sedation Investigators: Dexmedetomidine vesus midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 2012, 307:1151-1160. BACKGROUND Long-term sedation with midazolam or propofol in intensive care units (I...

Several propofol infusion platforms have been devised to address the inherent safety problems associated with propofol administration. Patient-controlled and target-controlled infusion systems have been described in the literature, and the Sedasys closed-loop feedback system is in FDA review. No matter what the infusion platform, there are important safety concerns that should be addressed when...

Over the past decade, most Canadian intensive care units (ICUs) have adopted locally developed standardized protocols for delivery of analgesics and sedatives to patients who are undergoing mechanical ventilation to alleviate pain, anxiety, and agitation. Although I do acknowledge the benefits of protocol-ized care, not all patients have the same needs with respect to sedation and analgesia, so...

Background: Emergency physicians routinely perform emergency department procedural sedation (EDPS) with propofol and its safety is well established. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) enacted guidelines defining propofol as deep sedation and requiring administration by a physician. Common EDPS practice had been one-physician performing both the sedation and pr...

Thirty children presenting to the dental clinic of a pediatric hospital who required brief but urgent dental care, and who could not be satisfactorily examined or treated, were administered one of three medications--ketamine (Ketalar), 3 mg/kg; midazolam (Versed), 0.4 mg/kg; or sufentanil (Sufenta), 1.5 or 1.0 micrograms/kg--intranasally in a randomized, double-blinded protocol. The patients we...

Anesthetic protocols that allow quick induction, short processing time, and rapid reversal are necessary for researchers performing minimally invasive procedures (including morphometric measurements or attachment of radiocollars). The objective of this study was to evaluate the effectiveness of medetomidine and butorphanol as a substitute for xylazine in ketamine-based field immobilization prot...