These conflicting results are open to a number
of interpretations, including that daily interruption
is beneficial only when it results in a reduction
in the total dose of sedative administered.
The conflicting findings also highlight that the
results of daily interruption of sedation may be
context-specific and will depend on the population
being studied, protocol adherence, and
management of the control group. A randomized,
controlled trial in which all patients undergoing
mechanical ventilation received morphine
for the treatment of pain in an “analgesia first”
approach compared a protocol of no sedation
with the routine use of sedation with daily interruption.11
Patients who were assigned to the
protocol of no sedation had shorter stays in the
ICU and the hospital and more days without
mechanical ventilation