Monitoring of the depth of sedation in the intensive care unit

Pharmacological sedation on the intensive care unit (ICU) is frequently required to enable treatment to be safely and effectively delivered. However, its use is not without risk, especially if no attempt is made to monitor the depth of sedation. Commonly utilized sedation-scoring systems are easy to use, but unfortunately neuromuscular paralysis negates their usefulness and they are always open to criticism because of being subjective in nature. Consequently attention has been directed at the use of the processed EEG to monitor sedation. Auditory evoked responses have received much attention in the anaesthetic literature for monitoring awareness under anaesthesia, but practical problems may limit their usefulness in the intensive care unit. The Bispectral Index can be monitored with easily interpretable and portable equipment and shows promise as a depth of sedation monitor in this setting