The way each ICU sedates its patients will depend on many factors. The number of doctors and nurses, design of the ICU (open plan versus single rooms) and the type of equipment are but some.

A typical regimen combines fentanyl and propofol. Midazolam and morphine given by IV boluses (2.5 mg) may be a suitable regimen if a prolonged period of ventilatory support is anticipated and the patient does not have renal or hepatic impairment. An infusion can be started if this dose is required to be given frequently. Hourly scoring of the level of sedation is essential, in addition to titration of the sedative agents to meet the sedation score target. Once an infusion of either drug is started then its need should be reviewed on a daily basis and its dose reduced or stopped (preferably before the morning ward round) until the patient is seen to recover from the effects of the drug. Unnecessary use of infusions may induce tolerance. It should be remembered that, although analgesics may provide sedation, sedatives do not provide analgesia; agitation caused by pain should be treated with an analgesic and not by increasing the dose of the sedative.