ABSTRACT
Traditionally, sedation was usually used to facilitate invasive ventilation. But sedation also deprives individuals of their autonomy, and to some extent their current awareness of being alive. Sedative drugs are "chemical restraint", an intervention only justified when there is a specific indication, and within the limits of that indication. The sedative drugs are opioids for example morphine, fentanyl, alfentanil, remifentanil, benzodiazepines for example diazepam, lorazepam, midazolam, anaesthetic agents for example propofol, ketamine, alpha 2 agonists for example clonidine, dexmedetomidine. Paralysis, whether from paralysing agents or pathology, prevents patients expressing awareness, invalidating almost all means of assessing sedation. The M. A. Ramsay scale, originally designed for drug research, was one of the earliest sedation scoring systems. Sedation holds should be carefully planned to ensure adequate comfort for procedures such as physiotherapy and insertion of any invasive devices, and be long enough for effects of sedatives previously given to fade.
