Sedation Practices and Preferences of Turkish Intensive Care Physicians: National Survey

Sedation is one of the most common practices applied in intensive care units (ICU) and the management of sedation, analgesia and delirium is a quality measure in ICUs. Several intensive care societies published guidelines regarding the use of sedatives and analgesics recently. In literature there are many survey studies investigating practices of sedation in ICUs of different countries, but knowledge of the sedation practices of intensive care physicians in Turkey is lacking. The aim of this study was to provide a baseline knowledge on this matter and to establish some points to be improved. An electronic survey form, consisting of 34 questions was generated with google forms, posted to 1700 email addresses and 429 returned (25%). The survey included questions about demographics and choices and routines of sedation, analgesia, neuromuscular blockers and delirium administration. Ninety-six percent of the respondents indicated that they practiced sedation in their ICUs and mechanical ventilation was checked as the primary indication (94%). On the question regarding drug choices for sedation, midazolam was the most preferred agent (90%). About pain questions, the most used evaluation tool was visual analogue scale (69.0%) and 83% of the respondents preferred to use tramadol for pain, followed by paracetamol (81.6%). Of the participants, 50.5% indicated that they routinely evaluated delirium and 56% of them used confussion assessment method for ICU. The awareness of 2013 American College of Critical Care Medicine (ACCM) guideline for the management of pain, agitation, and delirium was only 38%. The results of this survey have indicated some areas to be improved, such as low incidence of written sedation protocols, frequent use of benzodiazepines, and delirium screening. A national guideline should be prepared taking pain, agitation, and delirium in focus.