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1 "Seungho Jung"
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Original Article
Pharmacology
Inhalation sedation for postoperative patients in the intensive care unit: initial sevoflurane concentration and comparison of opioid use with propofol sedation
Seungho Jung, Sungwon Na, Hye Bin Kim, Hye Ji Joo, Jeongmin Kim
Acute Crit Care. 2020;35(3):197-204.   Published online August 10, 2020
DOI: https://doi.org/10.4266/acc.2020.00213
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  • 4 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Background
Although the use of volatile sedatives in the intensive care unit (ICU) is increasing in Europe, it remains infrequent in Asia. Therefore, there are no clinical guidelines available. This study investigates the proper initial concentration of sevoflurane, a volatile sedative that induces a Richmond agitation-sedation scale (RASS) score of –2 to –3, in patients who underwent head and neck surgery with tracheostomy. We also compared the amount of postoperative opioid consumption between volatile and intravenous (IV) sedation.
Methods
We planned a prospective study to determine the proper initial sevoflurane concentration and a retrospective analysis to compare postoperative opioid consumption between volatile sedation and propofol sedation. Patients scheduled for head and neck surgery with tracheostomy and subsequent postoperative sedation in the ICU were enrolled.
Results
In this prospective study, the effective dose 50 (ED50) of initial end-tidal sevoflurane concentration was 0.36% (95% confidence interval [CI], 0.20 to 0.60%), while the ED 95 was 0.69% (95% CI, 0.60 to 0.75%) based on isotonic regression methods. In this retrospective study, remifentanil consumption during postoperative sedation was significantly lower in the sevoflurane group (2.52±1.00 µg/kg/hr, P=0.001) than it was in the IV propofol group (3.66±1.30 µg/kg/hr).
Conclusions
We determined the proper initial end-tidal concentration setting of sevoflurane for patients with tracheostomy who underwent head and neck surgery. Postoperative sedation with sevoflurane appears to be a valid and safe alternative to IV sedation with propofol.

Citations

Citations to this article as recorded by  
  • Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
    V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev
    Medicina Intensiva.2023; 47(5): 267.     CrossRef
  • Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
    V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev
    Medicina Intensiva (English Edition).2023; 47(5): 267.     CrossRef
  • Inhaled Sedation with Volatile Anesthetics for Mechanically Ventilated Patients in Intensive Care Units: A Narrative Review
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    Journal of Clinical Medicine.2023; 12(3): 1069.     CrossRef
  • Sedation with Sevoflurane versus Propofol in COVID-19 Patients with Acute Respiratory Distress Syndrome: Results from a Randomized Clinical Trial
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    Journal of Personalized Medicine.2023; 13(6): 925.     CrossRef
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  • Sedation of patients in intensive care units. Guidelines
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    Anesteziologiya i reanimatologiya.2023; (5): 6.     CrossRef
  • Inhaled volatile anesthetics in the intensive care unit
    Erin D Wieruszewski, Mariam ElSaban, Patrick M Wieruszewski, Nathan J Smischney
    World Journal of Critical Care Medicine.2023;[Epub]     CrossRef
  • Prospects of inhalation sedation in intensive care
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    Anesteziologiya i reanimatologiya.2022; (3): 84.     CrossRef
  • Análisis nacional de la sedación aplicada en pacientes de cuidados críticos
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ACC : Acute and Critical Care