[Awakening of intensive care patients after prolonged continuous sedation]

A study was made of the degree of orientation, cooperation, and anxiety of patients admitted to the Intensive Care Unit of the Hospital de la Santa Creu i Sant Pau (level III), at the conclusion of prolonged continuous sedation. Recovery time was evaluated, understood as the time required to achieve orientation in time, place, and person. The study was descriptive. An analysis was made of 37 patients who met inclusion criteria between July 1995 and March 1996. After discontinuing sedation, the Glasgow assessment was carried out (modified by Cook and Palma) every four hours until a score of > or = 14 was obtained. From then on, the degree of anxiety, using the Hamilton scale, and cooperation and orientation, using our own scales, were evaluated four times a day. The assessment concluded when the patient was oriented in time, space, and person. We recorded age, sex, disease, disease severity, previous admissions, type of sedation, need for additional bolus injections, and the state of anxiety as perceived by family members. Mean age of patients was 65.1 +/- 13.3 years; 81.1% were men. Respiratory disease was the most common pathology, mean SAPS was 10.7 +/- 2.6, and the most frequently administered drug was midazolam (81%). Patients required an average of 15 hours (164-0) to awaken and tended to taken longer to awake with midazolam. Once the were awake, the required 10 hours (48-0) hours before the were completely oriented. The degree of anxiety was mild and cooperation was regular during all measurements. No relation was found between variables. Our results suggest that a care plan designed to shorten temporal disorientation and promote cooperation would improve the quality of awakening.