Safer sedation for ventilated patients. A new application for etomidate

Abstract

A technique is described for sedation of ventilated patients. Six patients who underwent major maxillofacial surgery were given low dose infusions of etomidate and fentanyl for postoperative sedation. Measurements of respiratory function were recorded before and during the period of intermittent positive pressure ventilation. Plasma etomidate levels were estimated. After initial stabilisation on almost constant rate of infusion was used to provide a reproducible level of sedation from which the patients were easily aroused. All patients maintained an adequate minute volume when disconnected from the ventilator. All measured and derived respiratory indices remained within normal limits. Patients exhibited amnesia throughout the period of infusion. All patients found this method of sedation pleasant. This technique may be recommended as an alternative to conventional methods of sedation for ventilated patients.