Propofol Sedation Study
Condition: Anesthesia
Study type: Observational

Summary: 
      Purpose of Protocol: The purpose of this study will be to compare the clinical utility of
      Propofol sedation with and without the use of the ICU Sedation Protocol. Patients will be
      treated according to the attending/consulting preference. No attempt will be made to
      influence the patient's routine care and management. The study will compare the average
      hourly infusion rates for the Propofol administration, as well as obtain the nursing staffs
      evaluation regarding the ease of neurological assessment during each 12 hour shift
    

Detailed description: 
      Study Objectives and Design: Propofol is a short-acting sedative that is easily titratable,
      and is approved for use in ventilated patients. The clinical usefulness of continuous
      intravenous infusion of Propofol has been demonstrated in the management of ventilated ICU
      patients. In addition, its short duration of action permits repeated neurological assessments
      to be carried out in patients with neurotrauma.

      Despite these benefits, Propofol is not without some drawbacks, including a lack of analgesic
      effects, dose dependent lowering of blood pressure, and significant expense. To address these
      issues, the PI developed an ICU Sedation Protocol that combines a titrated continuous
      infusion of intravenous morphine sulfate with the Propofol infusion to achieve the desired
      level of sedation. This ICU Sedation Protocol has been approved for use at Scottsdale
      Healthcare since 2004, and printed copies are available at all ICU nursing stations on the
      Osborn campus.

      At the present time, the ICU Sedation Protocol is used regularly by only two of the five
      neurosurgeons that care for the neurotrauma patients at the Osborn campus. The remaining
      three neurosurgeons prefer to use a continuous Propofol infusion with intermittent doses of
      intravenous morphine sulfate.

      The purpose of the study will be to compare the clinical utility of Propofol sedation with
      and without the use of the ICU Sedation Protocol. Patients will be treated according to the
      attending neurosurgeons preference. No attempt will be made to influence the patient's
      routine care and management. The study will compare the average hourly infusion rates for
      Propofol administration, as well as evaluating the difficulty of neurological assessment, and
      the ease of weaning to extubation.

      This is a prospective, non-randomized, open treatment protocol open to ICU patients at
      Scottsdale Healthcare Osborn. Only patients with neurotrauma that require intubation will be
      eligible for enrollment. Patients will be treated according to the consulting neurosurgeons
      preference. No attempt will be made to influence the patient's routine care and management,
      as already stated. The choice of sedation type and use of the ICU Sedation Protocol will be
      at the consulting neurosurgeons discretion.

      Involvement in the protocol will cease when continuous intravenous sedation is discontinued
      for more than 24 hours, the patient is extubated or undergoes tracheostomy, or is transferred
      from the ICU.
    

Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Neurotrauma ICU patients brought to our level one trauma facility requiring intubation.