The ideal level of sedation should leave a patient lightly asleep but easily roused. Opioids, in combination with a benzodiazepine or propofol, are currently the most frequently used agents for sedation, although benzodiazepines are associated with delirium and are increasingly avoided.

The most common indication for the therapeutic use of opioids is to provide analgesia. They are also able to elevate mood and suppress the cough reflex. This antitussive effect is a useful adjunct to their analgesic effects in patients who need to tolerate a tracheal tube.

Propofol has achieved widespread popularity for sedation. It is easily titrated to achieve the desired level of sedation and its effects end rapidly when the infusion is stopped, even after several days of use. Propofol is ideal for short periods of sedation on the ICU, and during weaning when longer-acting agents are being eliminated. Some clinicians recommend propofol for long-term sedation.

Currently, new sedative and analgesic drugs are designed to be shortacting. This means that they usually have to be given by continuous IV infusion. The increased cost of these drugs may be justifiable if they give better control and more predictable analgesia and sedation, and allow quicker weaning from ventilatory support.