Sedation modulates recognition of novel stimuli and adaptation to regular stimuli in critically ill adults

Clifford, James O.; Buchman, Timothy G.

doi:10.1097/00003246-200203000-00020

Cited by 5 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, some degree of residual sedative effect due to potentially impaired metabolism might have influenced our findings. Clifford and Buchman [18] reported that the combination of benzodiazepine and fentanyl affected information processing in response to novel and standard stimuli in a different manner than the combination of propofol and fentanyl in intensive care patients. Nevertheless, both of these drug combinations globally reduced the amplitudes of the responses to all stimuli as the sedative drug dose increased, in a manner similar to that in our study.…”

Section: Discussionmentioning

confidence: 99%

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

et al. 2004

View full text Add to dashboard Cite

Introduction In this observational pilot study we evaluated the electroencephalogram (EEG) and auditory event-related potentials (ERPs) before and after discontinuation of propofol sedation in neurologically intact intensive care patients. Methods Nineteen intensive care unit patients received a propofol infusion in accordance with a sedation protocol. The EEG signal and the ERPs were measured at the frontal region (Fz) and central region (Cz), both during propofol sedation and after cessation of infusion when the sedative effects had subsided. The EEG signal was subjected to power spectral estimation, and the total root mean squared power and spectral edge frequency 95% were computed. For ERPs, we used an oddball paradigm to obtain the N100 and the mismatch negativity components. Results Despite considerable individual variability, the root mean squared power at Cz and Fz (P = 0.004 and P = 0.005, respectively) and the amplitude of the N100 component in response to the standard stimulus at Fz (P = 0.022) increased significantly after interruption to sedation. The amplitude of the N100 component (at Cz and Fz) was the only parameter that differed between sedation levels during propofol sedation (deep versus moderate versus light sedation: P = 0.016 and P = 0.008 for Cz and Fz, respectively). None of the computed parameters correlated with duration of propofol infusion. Conclusion Our findings suggest that use of ERPs, especially the N100 potential, may help to differentiate between levels of sedation. Thus, they may represent a useful complement to clinical sedation scales in the monitoring of sedation status over time in a heterogeneous group of neurologically intact intensive care patients.

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

et al. 2004

View full text Add to dashboard Cite

show abstract

“…During mechanical ventilation, sedation has become an important component of the treatment, and intubated patients are frequently treated with sedatives (Young et al, 2000;Hurford, 2002;Izurieta and Rabatin, 2002). However, knowledge about the impact of pharmacological sedation on severely ill patients' memory and perception of discomfort is sparse (Wagner et al, 1997;Jones et al, 2000a;Capuzzo et al, 2001;Clifford and Buchman, 2002;Rundshagen et al, 2002), and no studies have focused on the relationship between mechanically ventilated patients' stressful experiences and the use of sedatives, including the depth of sedation.…”

Section: Introductionmentioning

confidence: 99%

Stressful experiences in relation to depth of sedation in mechanically ventilated patients

Samuelson

Lundberg

Fridlund

2007

Nursing in Critical Care

105

View full text Add to dashboard Cite

In mechanically ventilated patients, sedatives and analgesics are commonly used to ensure comfort, but there is no documented knowledge about the impact of depth of sedation on patients' perception of discomfort. The aim of this study was, therefore, to investigate the relationship between stressful experiences and intensive care sedation, including the depth of sedation. During 18 months, 313 intubated mechanically ventilated adults admitted to two general intensive care units (ICU) for more than 24 h were included. Patients (n = 250) were interviewed on the general ward 5 days after ICU discharge using the ICU Stressful Experiences Questionnaire. Patient data including sedation scores as measured by the Motor Activity Assessment Scale (MAAS) were collected from hospital records after the interview. Of the 206 patients with memories of the intensive care, 82% remembered at least one experience as quite a bit or extremely bothersome. Multivariate analyses showed that higher proportion of MAAS score 3 (indicating more periods of wakefulness), longer ICU stay and being admitted emergent were factors associated with remembering stressful experiences of the ICU as more bothersome. The findings indicate that the depth of sedation has an impact on patients' perception of stressful experiences and that light sedation compared with heavy seems to increase the risk of perceiving experiences in the ICU as more bothersome. In reducing discomfort, depth of sedation and patient comfort should be assessed regularly, non-pharmacological interventions taken into account and the use of sedatives and analgesics adapted to the individual requirements of the patient.

show abstract

“…Although there are numerous reasons for disturbed memory and amnesia in critically ill patients [15,16,17], the amnestic properties of SAAs make the impact on memory evident [18]. A dose-dependent responsiveness has been suggested between commonly administered sedatives in the ICU and the formation and retention of memory [19,20]. Recent studies focusing on the relationship between SAAs and memory of the ICU have included measures of days and amount of sedation [21,22].…”

Section: Introductionmentioning

confidence: 99%

Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients

2006

View full text Add to dashboard Cite

show abstract

Sedation modulates recognition of novel stimuli and adaptation to regular stimuli in critically ill adults

Cited by 5 publications

References 32 publications

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

Stressful experiences in relation to depth of sedation in mechanically ventilated patients

Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients

Contact Info

Product

Resources

About