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Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients
CONTEXT: Sleep deprivation is a common problem on intensive care units (ICUs) influencing not only cognition, but also cellular functions. An appropriate sleep-wake cycle should therefore be maintained to improve patients’ outcome. Multiple disruptive factors on ICUs necessitate the administration o...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033854/ https://www.ncbi.nlm.nih.gov/pubmed/24872650 http://dx.doi.org/10.4103/0972-5229.130572 |
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author | Engelmann, Cornelius Wallenborn, Jan Olthoff, Derk Kaisers, Udo X. Rüffert, Henrik |
author_facet | Engelmann, Cornelius Wallenborn, Jan Olthoff, Derk Kaisers, Udo X. Rüffert, Henrik |
author_sort | Engelmann, Cornelius |
collection | PubMed |
description | CONTEXT: Sleep deprivation is a common problem on intensive care units (ICUs) influencing not only cognition, but also cellular functions. An appropriate sleep-wake cycle should therefore be maintained to improve patients’ outcome. Multiple disruptive factors on ICUs necessitate the administration of sedating and sleep-promoting drugs for patients who are not analgo-sedated. AIMS: The objective of the present study was to evaluate sleep quantity and sleep quality in ICU patients receiving either propofol or flunitrazepam. SETTINGS AND DESIGN: Monocentric, randomized, double-blinded trial. MATERIALS AND METHODS: A total of 66 ICU patients were enrolled in the study (flunitrazepam n = 32, propofol n = 34). Propofol was injected continuously (2 mg/kg/h), flunitrazepam as a bolus dose (0.015 mg/kg). Differences between groups were evaluated using a standardized sleep diary and the bispectral index (BIS). STATISTICAL ANALYSIS USED: Group comparisons were performed by Mann-Whitney U-Test. P < 0.05 was considered to be statistically significant. RESULTS: Sleep quality and the frequency of awakenings were significantly better in the propofol group (Pg). In the same group lower BIS values were recorded (median BIS propofol 74.05, flunitrazepam 78.7 [P = 0.016]). BIS values had to be classified predominantly to slow-wave sleep under propofol and light sleep after administration of flunitrazepam. Sleep quality improved in the Pg with decreasing frequency of awakenings and in the flunitrazepam group with increasing sleep duration. CONCLUSIONS: Continuous low-dose injection of propofol for promoting and maintaining night sleep in ICU patients who are not analgo-sedated was superior to flunitrazepam regarding sleep quality and sleep structure. |
format | Online Article Text |
id | pubmed-4033854 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-40338542014-05-28 Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients Engelmann, Cornelius Wallenborn, Jan Olthoff, Derk Kaisers, Udo X. Rüffert, Henrik Indian J Crit Care Med Research Article CONTEXT: Sleep deprivation is a common problem on intensive care units (ICUs) influencing not only cognition, but also cellular functions. An appropriate sleep-wake cycle should therefore be maintained to improve patients’ outcome. Multiple disruptive factors on ICUs necessitate the administration of sedating and sleep-promoting drugs for patients who are not analgo-sedated. AIMS: The objective of the present study was to evaluate sleep quantity and sleep quality in ICU patients receiving either propofol or flunitrazepam. SETTINGS AND DESIGN: Monocentric, randomized, double-blinded trial. MATERIALS AND METHODS: A total of 66 ICU patients were enrolled in the study (flunitrazepam n = 32, propofol n = 34). Propofol was injected continuously (2 mg/kg/h), flunitrazepam as a bolus dose (0.015 mg/kg). Differences between groups were evaluated using a standardized sleep diary and the bispectral index (BIS). STATISTICAL ANALYSIS USED: Group comparisons were performed by Mann-Whitney U-Test. P < 0.05 was considered to be statistically significant. RESULTS: Sleep quality and the frequency of awakenings were significantly better in the propofol group (Pg). In the same group lower BIS values were recorded (median BIS propofol 74.05, flunitrazepam 78.7 [P = 0.016]). BIS values had to be classified predominantly to slow-wave sleep under propofol and light sleep after administration of flunitrazepam. Sleep quality improved in the Pg with decreasing frequency of awakenings and in the flunitrazepam group with increasing sleep duration. CONCLUSIONS: Continuous low-dose injection of propofol for promoting and maintaining night sleep in ICU patients who are not analgo-sedated was superior to flunitrazepam regarding sleep quality and sleep structure. Medknow Publications & Media Pvt Ltd 2014-04 /pmc/articles/PMC4033854/ /pubmed/24872650 http://dx.doi.org/10.4103/0972-5229.130572 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Engelmann, Cornelius Wallenborn, Jan Olthoff, Derk Kaisers, Udo X. Rüffert, Henrik Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title | Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title_full | Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title_fullStr | Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title_full_unstemmed | Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title_short | Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients |
title_sort | propofol versus flunitrazepam for inducing and maintaining sleep in postoperative icu patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033854/ https://www.ncbi.nlm.nih.gov/pubmed/24872650 http://dx.doi.org/10.4103/0972-5229.130572 |
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