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Master Thesis

Évaluation de l’efficacité de la sédation par isoflurane inhalé chez des patients en réanimation chirurgicale au CHU de Rouen : une étude rétrospective

Abstract : Introduction: Sedation is a major issue in intensive care units by ensuring the comfort of the patient during the implementation of therapies such as mechanical ventilation and by playing a full role in the treatment of certain illnesses. The level of sedation must be adapted to the desired objective and sedation must be able to stop quickly once it is no longer necessary. Conventional sedatives (midazolam and propofol) present a risk of addiction in case of prolonged administration leading to a decrease of efficacy. Isoflurane, a volatile halogenated agent, does not present this risk of tachyphylaxis and can now be easily administered in intensive care units using to the Mirus device. The aim of this study was to evaluate the efficacy of inhaled isoflurane sedation in patients hospitalized in surgical intensive care at the Rouen University Hospital. Patients and methods: This was a retrospective observational, monocentric study conducted in surgical intensive care at Rouen University Hospital. All patients sedated with inhaled isoflurane between January 1, 2018 and July 1, 2020 were included. The primary endpoint was the efficacy of sedation 3 hours before and after the sedation switch for isoflurane defined by the difference between the observed and prescribed sedation level, assessed on a RASS scale. Secondary endpoints were the dosage of other sedatives used and the tolerance of isoflurane sedation. Results: In 30 months, 26 patients received inhaled isoflurane sedation. Under conventional sedation, 14 patients (59%) had a sufficient level of sedation, after changing to isoflurane sedation, 26 patients (100%) had sufficient sedation (p = 0,001). Sedation with isoflurane decreased the dosage of sufentanil (30 (20 ; 40) µg/h before and 20 (10 ; 20) µg/h after isoflurane switch, p = 0.01). There were no clinico-biological signs of poor isoflurane sedation tolerance. Conclusion: Inhaled isoflurane sedation with the Mirus system appears to be a good alternative for patients experiencing difficult sedation in surgical intensive care units.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03026105
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Submitted on : Thursday, November 26, 2020 - 3:25:39 PM
Last modification on : Wednesday, October 27, 2021 - 7:49:41 AM
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  • HAL Id : dumas-03026105, version 1
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Étienne Allard. Évaluation de l’efficacité de la sédation par isoflurane inhalé chez des patients en réanimation chirurgicale au CHU de Rouen : une étude rétrospective. Médecine humaine et pathologie. 2020. ⟨dumas-03026105⟩

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