Health care professionals’ knowledge of commonly used sedative, analgesic and neuromuscular drugs: A single center (Rambam Health Care Campus), prospective, observational survey

Autoři: Danny Epstein aff001;  Yaniv Steinfeld aff002;  Erez Marcusohn aff001;  Hanna Ammouri aff003;  Asaf Miller aff003
Působiště autorů: Department of Internal Medicine "B", Rambam Health Care Campus, Haifa, Israel aff001;  Orthopedic Surgery Division, Rambam Health Care Campus, Haifa, Israel aff002;  Medical Intensive Care Unit, Rambam Health Care Campus, Haifa, Israel aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227499



Pain management and sedation are important aspects in the treatment of hospitalized patients, especially those mechanically ventilated. In many hospitals, such patients are treated not only in intensive care units, but also in other wards. In the nineteen eighties, numerous studies demonstrated a wide array of misconceptions and inadequate knowledge related to commonly used sedative, analgesics and muscle relaxants which may prevent appropriate treatment. Since these publications, multiple studies have shown that appropriate sedation and analgesia are associated with improved clinical outcomes, educational programs were developed and guidelines published. Whether the personnel’s knowledge kept up with these changes is unknown. The aim of this study was to determine the current rate of misconceptions and knowledge gaps regarding commonly used sedative, analgesic and neuromuscular drugs.


In this prospective, observational, cross-sectional survey, a questionnaire was e-mailed to physicians and nurses routinely treating mechanically ventilated patients in Rambam Health Care Campus (Haifa, Israel).


355 questionnaires were returned. 82.54% knew that midazolam has no analgesic effect. 71–72% were familiar with the sedative effect of opiates. 27% believed that propofol has analgesic properties and 30.52% thought that rocuronium has a sedative effect.


Our findings demonstrate that although a lot has been done during the last decades in order to improve the treatment of critically ill patients, the rate of misconceptions regarding pharmacological characteristics of commonly used drugs is unacceptably high. We call for performance of similar surveys in other institutes and for immediate action to improve patients’ care.

Klíčová slova:

Physicians – Nurses – Surgical and invasive medical procedures – Analgesics – Intensive care units – Analgesia – Sedatives – Sedation


1. Sigakis MJG, Bittner EA. Ten myths and misconceptions regarding pain management in the ICU. Crit Care Med. 2015;43: 2468–2478. doi: 10.1097/CCM.0000000000001256 26308433

2. Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, 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: e825–e873. doi: 10.1097/CCM.0000000000003299 30113379

3. Patel SB, Kress JP. Sedation and analgesia in the mechanically ventilated patient. American Journal of Respiratory and Critical Care Medicine. 2012. pp. 486–497. doi: 10.1164/rccm.201102-0273CI 22016443

4. Paiement B, Boulanger M, Jones CW, Roy M. Intubation and other experiences in cardiac surgery: the consumer’s views. Can Anaesth Soc J. 1979;26: 173–80. doi: 10.1007/bf03006977 466561

5. Rockett M, Vanstone R, Chand J, Waeland D. A survey of acute pain services in the UK. Anaesthesia. 2017;72: 1237–1242. doi: 10.1111/anae.14007 28891060

6. Martyn JAJ, Mao J, Bittner EA. Opioid Tolerance in Critical Illness. Ingelfinger JR, editor. N Engl J Med. 2019;380: 365–378. doi: 10.1056/NEJMra1800222 30673555

7. Miller-Jones CMH, Williams JH. Sedation for ventilation. Anaesthesia. 1980;35: 1104–1107. doi: 10.1111/j.1365-2044.1980.tb05052.x 7004256

8. Paralysed with fear. Lancet (London, England). 1981;1: 427.

9. Loper KA, Butler S, Nessly M, Wild L. Paralyzed with pain: the need for education. Pain. 1989;37: 315–316. doi: 10.1016/0304-3959(89)90196-6 2569177

10. Marino PL and KMS. The ICU book. 4th editio. Baltimore: Williams & Wilkins; 2014.

11. Kress JP, Pohlman AS, Hall JB. Sedation and Analgesia in the Intensive Care Unit. Am J Respir Crit Care Med. 2002;166: 1024–1028. doi: 10.1164/rccm.200204-270CC 12379543

12. Peterson R. Constructing Effective Questionnaires. Constructing Effective Questionnaires. SAGE Publications, Inc.; 2014. doi: 10.4135/9781483349022

13. Story DA, Tait AR. Survey Research. Anesthesiology. 2019;130: 192–202. doi: 10.1097/ALN.0000000000002436 30688782

14. Shehabi Y, Bellomo R, Mehta S, Riker R, Takala J. Intensive care sedation: the past, present and the future. Crit Care. 2013;17: 322. doi: 10.1186/cc12679 23758942

15. Hersch M, Sonnenblick M, Karlic A, Einav S, Sprung CL, Izbicki G. Mechanical ventilation of patients hospitalized in medical wards vs the intensive care unit—an observational, comparative study. J Crit Care. 2007;22: 13–17. doi: 10.1016/j.jcrc.2006.06.004 17371738

16. Brown TB, Lovato LM, Parker D. Procedural sedation in the acute care setting. Am Fam Physician. 2005;71: 85–90. 15663030

17. Rowley P, Boncyk C, Gaskell A, Absalom A, Bonhomme V, Coburn M, et al. What do people expect of general anaesthesia? Br J Anaesth. 2017;118: 486–488. doi: 10.1093/bja/aex040 28403409

18. Jones SS, Rudin RS, Perry T, Shekelle PG. Health Information Technology: An Updated Systematic Review With a Focus on Meaningful Use. Ann Intern Med. 2014;160: 48–54. doi: 10.7326/M13-1531 24573664

19. Williams CN, Bratton SL, Hirshberg EL. Computerized decision support in adult and pediatric critical care. World J Crit care Med. 2013;2: 21–8. doi: 10.5492/wjccm.v2.i4.21 24701413

20. Keon-Cohen Z, Myles PS, Story DA. A survey of Australian and New Zealand anaesthetists’ attitudes towards resuscitation orders in the perioperative setting. Anaesth Intensive Care. 2017;45: 396–402. doi: 10.1177/0310057X1704500316 28486899

21. Braun AR, Leslie K, Merry AF, Story D. What are we telling our patients? A survey of risk disclosure for anaesthesia in Australia and New Zealand. Anaesth Intensive Care. 2010;38: 935–8. doi: 10.1177/0310057X1003800520 20865882

22. Du Y, Wolf IK, Knopf H. Association of psychotropic drug use with falls among older adults in Germany. Results of the German Health Interview and Examination Survey for Adults 2008–2011 (DEGS1). PLoS One. 2017;12. doi: 10.1371/journal.pone.0182432 28792521

23. Mohammadi E, Thelwall M, Kwasny M, Holmes KL. Academic information on Twitter: A user survey. PLoS ONE. Public Library of Science; 2018. doi: 10.1371/journal.pone.0197265 29771947

24. Draugalis JLR, Coons SJ, Plaza CM. Best practices for survey research reports: A synopsis for authors and reviewers. American Journal of Pharmaceutical Education. American Association of Colleges of Pharmacy; 2008. doi: 10.5688/aj720111 18322573

Článok vyšiel v časopise


2020 Číslo 1

Najčítanejšie v tomto čísle

Tejto téme sa ďalej venujú…

Zabudnuté heslo

Nemáte účet?  Registrujte sa

Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.


Nemáte účet?  Registrujte sa