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Related Concept Videos

Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

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Related Experiment Video

Updated: May 27, 2026

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor
07:51

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Published on: September 29, 2020

Current sedation practices: lessons learned from international surveys.

Sangeeta Mehta1, Iain McCullagh, Lisa Burry

  • 1Medical Surgical Intensive Care Unit, Mount Sinai Hospital, 600 University Avenue Room 18-216, Toronto, Ontario M5G 1X5, Canada. geeta.mehta@utoronto.ca

Anesthesiology Clinics
|November 15, 2011
PubMed
Summary

Surveys reveal significant international variations in intensive care unit (ICU) sedation and analgesia practices. Despite guidelines, physician practice often differs, highlighting barriers to implementing evidence-based care.

Related Experiment Videos

Last Updated: May 27, 2026

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor
07:51

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Published on: September 29, 2020

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Surveys are valuable for understanding current medical practices, despite inherent limitations like responder bias and discrepancies between reported and actual behaviors.
  • Previous Canadian surveys in 2002 and 2008 highlighted significant differences between physician-reported practices and observational data.
  • Data from surveys may be skewed by reliance on single informants (e.g., nurse managers) or limited specialist representation (e.g., anesthesiologists in German ICUs).

Purpose of the Study:

  • To identify international variations in the use of sedative and analgesic drugs in intensive care units (ICUs).
  • To assess changes in sedation and analgesia practices over the past decade.
  • To explore barriers to the implementation of evidence-based sedation and analgesia guidelines in routine ICU care.

Main Methods:

  • Analysis of international survey data on sedative and analgesic drug utilization in ICUs.
  • Comparison of current practices with historical data and published guidelines.
  • Identification of trends in drug selection and sedation depth.

Main Results:

  • Substantial international variation exists in the use of sedative and analgesic drugs.
  • A notable trend towards lighter sedation and a shift from benzodiazepines to propofol, and from morphine to fentanyl and remifentanil has been observed over the last 10 years.
  • Actual clinical practice frequently deviates from recommended practices, indicating a low impact of clinical trials and guidelines on physician behavior.

Conclusions:

  • Surveys, despite limitations, provide crucial insights into current ICU sedation and analgesia practices and identify areas for improvement.
  • Significant barriers impede the integration of sedation scales, protocols, and daily interruption strategies into routine ICU care.
  • Further research and targeted educational interventions are needed to bridge the gap between evidence-based guidelines and actual clinical practice in ICUs.