Analgesia-First Sedation in Trauma Patients

The study's aim is to ascertain the best approach for providing sedation and pain management for patients who have sustained trauma and are requiring respiratory support from a mechanical ventilator. The common approach to patients who need mechanical ventilation is to provide continuous drips of sedatives and pain medicine and awaken the patient once a day to check the brain functions. Another approach is to provide pain medicine and reserve sedatives for only a short duration when needed. The difference between approaches has not been studied in Trauma patients.

Inclusion Criteria:≥ 18 years of ageMechanically ventilated with an expected duration of MV ≥ 48hInitiated continuous sedative/analgesic infusions by the ICU teamPatient is a candidate for MV weaningExclusion Criteria:Admission after resuscitation from cardiac arrestSignificant neurological deficit due to a chronic disorderHistory of alcohol dependence and/or other illicit drug abusePrior administration of continuous sedative/analgesic from a transferring institutionPatient receiving neuromuscular blocking agentsAllergy to midazolam, lorazepam, and/or propofol