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2017, Number 3

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Rev Mex Anest 2017; 40 (3)

Comparison of two sedative-analgesia regimens in ventilated critical patients at the Hospital «Hermanos Ameijeiras»

Quisilema-Cadena JM, Cordero-Escobar I, González-Hernández O

Language: Spanish
References: 29
Page: 155-161
PDF size: 234.93 Kb.


ABSTRACT

Introduction: Sedation in ventilated patients is a common practice. Ketamine is not a drug that has been studied for this purpose. Objectives: To evaluate the sedoanalgesic action of the combination midazolam-morphine and midazolam-ketamine in critically ventilated patients. Material and methods: A observational research was performed in patients with cooperative sedation criteria. They were randomly assigned to two groups: morphine or ketamine. Every 6 hours, the level of sedation was determined using the Ritchmond scale. The primary response variable was the time of successful extubation (from the start of intubation to 48 hours later). Patients were followed until discharge. Results: Of the 18 patients, 10 received morphine and 8 ketamine. The median on the Ritchmond scale was -3 points in both groups. There were no significant differences, according to successful extubation time (HR 0.99 [95% CI 0.22-4.45], p = 0.991). The groups also did not differ in adverse events (70% versus 50%, p = 0.630), ICU mortality (70% versus 75%, p = 1.000), in-hospital mortality (80% versus 75%; p = 1.000). The distribution of mortality, between groups were similar p = 1,000. The drug did not influence ICU stay (p = 0.645) or hospital stay (p = 0.787). Conclusions: Ketamine was as effective as morphine for the cooperative sedation of critically ventilated patients mechanically. There was no association between mortality and the use of both therapeutic regimens.


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