Challenges in Sedating COVID-19 Patients

Vol 8 | Issue 2 | May-August 2022 | Page: 06-11 | Jyoti Shinde, Moosa Awladthani, Sanjay Shinde, Sathiya Murthi, Manthan Shinde

DOI: 10.13107/jaccr.2022.v08i02.199


Author: Jyoti Shinde [1], Moosa Awladthani [1], Sanjay Shinde [2], Sathiya Murthi [3], Manthan Shinde [4]

[1] Department of Anaesthesia & Intensive Care Unit, Armed Forces Hospital, Muscat.
[2] Department of Urology, Armed Forces Hospital, Muscat.
[3] Statistics Specialist, Oman Medical Speciality Board, Muscat.
[4] Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Address of Correspondence
Dr. Jyoti Shinde
Specialist Anaesthetist, Department of Anaesthesia & Intensive Care Unit, Armed Forces Hospital, Muscat.
E-mail: jyotisanjay@hotmail.com


Abstract


Objectives: To study the sedation challenges in patients with COVID-19-induced acute respiratory distress syndrome.
Methods: A retrospective analysis of sedation challenges in critically ill patients due to COVID-19 pneumonia with acute respiratory distress syndrome at Armed Forces Hospital. Patients requiring continuous infusion or intermittent sedation, or oral/IV sedative therapy, were recorded. The Richmond Agitation and Sedation Scale (RASS) was used as a validated tool to assess sedation. IBM SPSS Version 25 was used for the statistical analysis. Categorical variables were presented with frequency and percentages, as well as continuous mean or SD median or interquartiles.
Results: In total, 100 patients with a mean age of 49.5 ± 14.89 years who recovered, and 67.68 ± 12.75 years who died, were included in the study. To achieve the prescribed sedation level, we observed the need for an intravenous (IV) infusion of two sedatives in 30% of the patients, and three sedatives in 27% of the patients, respectively. Apparently, oral concurrent sedation or analgesia or combinations of these were also prescribed, showing 35% of patients requiring a single drug, whereas 30% required 2-3 drug combinations. The analysis showed that the majority of COVID-19 patients admitted to the ICU required unusually high doses of sedation compared to those available in the literature for non-COVID patients.
Conclusion: The global pandemic outbreak due to SARS CoV-2 continues to affect patients with mild to severe ARDS, requiring ventilation and sedation. High dosages of sedative agents were observed in patients with COVID-19-related ARDS. Several combinations of oral and IV sedatives were used to achieve the required levels of sedation.
Keywords: Respiratory Distress Syndrome, COVID-19, Hypnotics and Sedatives, Pandemics, Analgesia, Intensive Care Units.


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How to Cite this Article: Shinde J, Awladthani M, Shinde S, Murthi S, Shinde M | Challenges in Sedating COVID-19 Patients | Journal of Anaesthesia and Critical Care Case Reports | May-August 2022; 8(2): 06-11.

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