[Analgosedation of the ventilated intensive care patient]

Seven different schemes for analgesic anaesthesia were investigated for their clinical applicability, potential side effects, and impacts on circulation parameters of the systemic and pulmonary (peripheral) circulation as well as on the intracranial pressure. In all, so patients per group were treated. The results revealed different reactions of patients, such as a higher incidence of disturbances of the autonomic nervous system and excitation after medication withdrawal. Favourable effects not only on clinical reactions but also on circulation parameters were seen during fentanyl/midazolam or alfentanil/midazolam therapy. In several instances, a clear increase in the right atrial and the pulmonary arterial mean pressure as well as the intracranial pressure was observed during ketamine/flunitrazepam therapy. The combinations pethidine/promethazine or pethidine/flunitrazepam also showed clear side effects on the circulation and evoked an increase in the intracranial pressure. Fentanyl/midazolam or alfentanil/midazolam treatments were the most favourable combinations for most of the patients who were artificially respirated.