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. 2012 Nov;56(6):518-23.
doi: 10.4103/0019-5049.104565.

A review of the practice of sedation with inhalational anaesthetics in the intensive care unit with the AnaConDa(®) device

Satyajeet Misra  1 , Thomas Koshy
Affiliations

A review of the practice of sedation with inhalational anaesthetics in the intensive care unit with the AnaConDa(®) device

Satyajeet Misra et al. Indian J Anaesth. 2012 Nov.

Abstract

The intensive care unit (ICU) environment is often perceived to be hostile and frightening by patients due to unfamiliar surroundings coupled with presence of numerous personnel, monitors and other equipments as well as a loss of perception of time. Mechanical ventilation and multiple painful procedures that often need to be carried out in these critically ill patients add to their overall anxiety. Sedation is therefore required not only to allay the stress and anxiety, but also to allow for mechanical ventilation and other invasive therapeutic and diagnostic procedures to be performed. The conventional intravenous sedative agents used in ICUs suffer from problems of over sedation, tachyphylaxis, drug accumulation, organ specific elimination and often lead to patient agitation on withdrawal. All this tend to prolong the ventilatory as well as ICU and hospital discharge time, which increase the risk for infection and add to the overall increase in morbidity, mortality and hospital costs. In 2005, the anaesthetic conserving device (AnaConDa(®)) was marketed for ICU sedation with volatile anaesthetic agents. A number of trials have shown the effectiveness of using volatile anaesthetic agents for ICU sedation with the AnaConDa device. Compared with intravenous sedatives, use of volatile anaesthetic agents have resulted in shorter wake up and extubation time, lesser duration of mechanical ventilation and faster discharge from hospitals. This review shall focus on the benefits, technical pre-requisites and status of sedation with volatile anaesthetic agents in ICUs with the AnaConDa(®) device.

Keywords: Anaesthetic conserving device; ICU sedation; isoflurane; midazolam; propofol; sevoflurane.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Schematic diagram of the AnaConDa® device. (a) The device is inserted between the Y-piece and the patient instead of the usual heat moisture exchange filter. (b) Cross section of the device illustrating the mechanism of action. Refer text for details
See this image and copyright information in PMC

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