Critical Care Medicine-Neurologic Disorders>>>>>Analgesia, Sedation and Neuromuscular Blockade
Question 3#

You have just intubated a patient for respiratory failure and will be initiating a sedation regimen.

Which of the following would be the LEAST preferred choice for sedation?

A. Midazolam
B. Propofol
C. Fentany
D. Dexmedetomidine
E. Hydromorphone

Correct Answer is A


Correct Answer: A

The 2018 Society for Critical Care Medicine Clinical Practice Guidelines for management for pain and agitation/sedation recommend propofol or dexmedetomidine over benzodiazepines for sedation for shorter duration of mechanical ventilation. Benzodiazepine-based sedation regimens are strongly associated with ICU delirium and thus are the least preferred choice. The guidelines also recommend a protocol-based pain assessment for treating pain before assessing the need for sedation.


  1. Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825-e873.