BACKGROUND: Recent attention to adverse effects of intensive care unit (ICU) sedation has
led to the use of strategies that target a “lighter” depth of sedation. Among these strategies
are “analgosedation” protocols, which prioritize pain management and preferentially use IV
opioids before administration of continuously infused sedatives such as propofol or
midazolam. We hypothesized that using an analgosedation protocol would result in a
shorter duration of mechanical ventilation than a protocol with greater emphasis on IV …

Methods: Retrospective chart review of patients who required sedation for mechanical
ventilation in the medical ICU. A new sedation protocol utilizing an analgesia-first approach
with fentanyl was implemented in late 2012. This study compared a 2011 cohort to a similar
2013 cohort to determine the impact of this sedation approach. Duration of mechanical
ventilation, ICU length of stay, total dosage and cost of sedative medications (based on 2014
US dollars cost), Richmond Agitation Sedation Scale (RASS) scores, and in-hospital …