ABSTRACT

Sedatives help to relieve anxiety, encourage sleep, help the patient to synchronise with the ventilator and permit therapeutic procedures. The requirements for sedation vary greatly depending on the patient’s pathology, psychological state and intensity of the medical and nursing procedures being undertaken. Improving the patient’s environment may help to reduce the need for drugs. Effective communication and appropriate reassurance will help to relieve the patient’s anxiety. Many patients receiving mechanical ventilation will require sufficient sedation to keep them comfortable yet rousable to voice. Patients with a tracheostomy who are receiving assisted modes of ventilation may not require any sedation. Where indicated, epidural analgesia will prevent the need for large doses of systemic analgesia. Those requiring unphysiological modes of ventilation (e.g. inverse ratio), prone ventilation or control of intracranial hypertension or seizures, for example, will need heavy sedation.