PATIENT RECALL OF THERAPEUTIC PARALYSIS IN A SURGICAL CRITICAL CARE UNIT

Study Objective. To investigate patient recall of therapeutic paralysi s (TP) in a surgical critical care unit. Design. Prospectively applied structured interview of patients undergoing TP over 18 months. Settin g. Surgical critical care unit with 27 beds at a tertiary care univers ity teaching hospital. Patients. Forty patients admitted for postopera tive care after coronary artery bypass graft surgery, trauma, or gastr ointestinal surgery. Interventions. Patients received TP and concurren t sedation with benzodiazepines, propofol, and narcotics. Measurements and Main Results. After the end of TP patients were asked to recall t he experience, and their responses were ranked on a four-point ordinal scale. Four of 11 patients recalled mostly negative events and experi ences with TP, such as sleeplessness, discomfort, pain, anxiety, and i nconsistent caregiver communication. All patients with recall experien ced fear, anxiety, and sleeplessness. Single-drug therapy with propofo l and inadequate benzodiazepine dosing were linked to patient recall. Conclusions. Patient recollection from TP may be more common than appr eciated and is generally unpleasant. Adequate dosing with benzodiazepi nes and narcotics is warranted to prevent recall and discomfort.