Intravenous sedation is clinical practice in the ICU although intravenous sedative drugs and combination of drugs is well known to have disadvantages and side effects such as withdrawal (1), tolerance, accumulation and long wake up time after prolonged use (1,2). Many critical ill patients also have impaired hepatic and/or renal function which can delay elimination, as intravenous drugs are depended on adequate renal and liver function for normal elimination.

Many articles have suggested volatile agents and especially isoflurane as a more optimal sedative drug in the ICU (3, 4, 5, 6, 7, 8). Many advantages have been suggested such as a more reliable route of administration/extraction, few adverse effects on the cardio-respiratory system and hepatic, renal or adrenal function (3, 4, 5, 6, 10, 11) and no development of tolerance (5, 12).

Isoflurane is minimally metabolized (~ 0,2%) and elimination is independent of hepatic and renal function (5, 12) Isoflurane also has a low blood/gas partition coefficient making sedation easy to control.
As it is administered and extracted through the lungs recovery is rapid and predictable. Sedation level can rapidly be changed by changing the inspired concentration, which is useful in facilitating treatment procedures, such as changing dressing, insertion of chest drains etc. Isoflurane is also well known for treatment of bronchospasm and status epilepticus (14, 15).

Studies comparing isoflurane and midazolam for sedation of ICU patients has shown that isoflurane sedated patents recovered more rapidly and wake up time was shorter and more predictable (12, 13) with isoflurane.

Although it is well known that anaesthetic agents in the ICU are an attractive alternative to intravenous drugs it has not become clinical practice. The main reason for this is that it is complicated to administer in an easy and safe way. But there has been a REVOLUTION. AnaConDa with its unique design makes it easy to administer volatile anaesthetic agents in the ICU in a safe and simple way. The AnaConDa is inserted between the ET-tube and Y-piece in the ventilator circuit of an ordinary ICU ventilator. Dosing is easily facilitated by using an ordinary syringe pump and the gas concentration can easily be controlled through a gas monitor. As most of the agent is recycled to the patient the risk of pollution is limited and the risk is easily eliminated by using a simple scavenging system.

The AnaConDa makes you a master of sedatation