Intravenous sedation for the intubated and spontaneously breathing patient in the intensive care unit

A technique is described for the management of post-operative patients who have undergone major craniofacial surgery. Under supervision on the Intensive Care Unit, the patients breathe humidified, oxygen-enriched air through a naso-tracheal tube. Sedation and analgesia are provided by continuous infusions of etomidate (variable rate) and fentanyl (fixed rate), administered by volumetric infusion pumps (IMED 922). Six patients have been studied in detail and our results are presented. In conjunction with fentanyl, a mean infusion rate of 3.72 micrograms . kg-1 . min-1 of etomidate provided good sedation and analgesia, without clinically significant respiratory depression. The patients found the technique very acceptable and no side-effects were noted.