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Updated: May 23, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Analgosedation: a paradigm shift in intensive care unit sedation practice.

Sandeep Devabhakthuni¹, Michael J Armahizer, Joseph F Dasta

¹University of Pittsburgh Medical Center, Pittsburgh, PA, USA. sdevabha@rx.umaryland.edu

The Annals of Pharmacotherapy

|April 13, 2012

Summary

Analgosedation, prioritizing pain management before sedation, improves outcomes for critically ill patients. This approach reduces mechanical ventilation duration and intensive care unit (ICU) length of stay compared to traditional methods.

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Area of Science:

Critical Care Medicine
Pharmacology
Patient Outcomes

Background:

Current sedation practices in critically ill, mechanically ventilated patients are associated with adverse events, prolonged ventilation, and extended ICU stays.
Analgosedation is a patient-centered strategy that addresses pain and discomfort before administering sedative therapy.

Purpose of the Study:

To critically evaluate the efficacy and safety of analgosedation in managing agitation in critically ill, mechanically ventilated patients.
To compare analgosedation with standard sedative-hypnotic regimens regarding patient outcomes.

Main Methods:

A literature search was conducted using MEDLINE and Cochrane Library, including randomized controlled trials (RCTs) of mechanically ventilated patients over 18 years old.
Nine RCTs comparing remifentanil-based analgosedation with other agents (fentanyl, midazolam, morphine, propofol) and one trial comparing morphine to daily sedation interruption were reviewed.

Main Results:

Analgosedation, particularly with remifentanil, resulted in shorter mechanical ventilation duration, faster weaning, and reduced ICU length of stay compared to sedative-hypnotic regimens.
Remifentanil-based analgosedation demonstrated similar efficacy to fentanyl but with increased pain upon discontinuation.
The analgosedation strategy was well-tolerated, with no significant impact on hemodynamic stability.

Conclusions:

Analgosedation is an effective and safe method for managing sedation in the ICU, leading to better patient outcomes than traditional sedative-hypnotic approaches.
Further research is needed to fully elucidate the role of analgosedation, including studies involving nonopioid analgesics.