Pharmacoeconomic Consequences Of Analgesia in the Intensive Care Unit (ICU)

A Randomized, Open Label, Multicentre Study to Compare the Pharmaco-economic Implications of an Analgesia Based Regimen With Remifentanil and a Conventional Sedation Based Regimen Using Propofol in Medical and Post-surgical ICU Subjects Requiring Mechanical Ventilation for at Least 2 Days.

This study will be a multicentre randomized, open-label, phase IIIb study. This study will evaluate two different techniques of sedation: an analgesia based regimen with remifentanil versus a conventional sedation based regimen using propofol in subjects that require mechanical ventilation for at least 2 days in the ICU. The conventional sedation based regimen will consist of propofol combined with an opioid according to routine clinical practice (morphine, fentanyl, sufentanil or other as required) . The analgesia based regimen will consist of remifentanil, with propofol added on if required.

Inclusion Criteria:

• Medical and post-surgical patients admitted to ICU and requiring mechanical ventilation.
• Intubated subjects expected to require mechanical ventilation for longer than 48 hours after starting the study drug.
• Subjects requiring both analgesia and sedation with a regimen comprising a hypnotic agent and an opioid.

Exclusion Criteria:

• Diagnosis: cardiopulmonary resuscitation (CPR) in the previous 24 hours or expecting to require major surgery within the next three days

• Subject who, in the judgement of the investigator, has a life expectancy of 2 days or refrained or refuses full life support, which would limit the care provided

• Concurrent medications:

  • Requires or is likely to require neuromuscular blocking agents by continuous infusion to facilitate mechanical ventilation
  • Has or is likely to receive an epidural block during the treatment period