Sedative-analgesics use in Intensive Care: A Critical  analysis of prescribed analgo-sedatives, treatment  outcomes, and adverse drug events in adult patients at  Komfo Anokye Teaching Hospital :

Joseph Agyeman; Aliu Moomin; Moses  Siaw-Frimpong; Paa K. T. Adu-Gyamfi; Charles Ansah; Kwesi Boadu  Mensah

doi:10.46829/hsijournal.2025.6.7.1.1178-1186

Joseph Agyeman Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Aliu Moomin University of Aberdeen, Rowett Institute, Foresterhill Campus, Aberdeen, United Kingdom,
Moses Siaw-Frimpong Anaesthesia and Intensive Care Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Paa K. T. Adu-Gyamfi Pentecost University College, Faculty of Health and Allied Sciences, Department of Nursing and Midwifery, Accra, Ghana.
Charles Ansah Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Kwesi Boadu Mensah Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

DOI: https://doi.org/10.46829/hsijournal.2025.6.7.1.1178-1186

Keywords: Adverse drug events, analgo-sedation, critical care, intensive care, Teaching Hospitals, treatment outcomes

Abstract

Background: Studies on the use of sedative-analgesics are limited in Africa and developing countries despite their high usage, benefits, and side effects among patients. Recent evidence on analgo-sedation suggests that protocols considering up-to-date scientific evidence and individual patient characteristics can improve treatment outcomes.
Objective: This study aimed to analyse the prescribed analgo-sedatives, protocols, outcomes and adverse events of sedative-analgesics in the ICU in a teaching hospital in Ghana.
Methods: This retrospective study reviewed data from adult patients admitted to the ICU of KATH from January 2017 to December 2019. Patient characteristics such as socio-demography, sedative-analgesic prescribed, and respondents' outcomes, including length of stay, survival and associated adverse drug events (ADE), were collected for analysis. The chi-square test was used to analyse associations between analgo sedative usage, speciality and ICU stay, with p < 0.05 considered statistically significant.
Results: The most prescribed analgo-sedatives were Morphine+Midazolam (53.24%), Morphine (16.19%) and Midazolam (6.47%). The relative risk of developing an ADE with analgo-sedation use was 2.1 (p < 0.001). The median duration of stay was longer in sedated patients (3 days, IQR: 2-9) compared to non-sedated ones (1 day, IQR: 1-3, p < 0.001). Analgo-sedation also significantly increased the occurrence of adverse events (RR 2.1; p < 0.001). Patients who experienced ADEs had 98% decreased odds of survival compared to those without ADEs
(aOR: 0.02, 95% CI: 0.01 - 0.05, p < 0.001). Critically ill patients had 73% lower odds of survival than severely ill patients (aOR: 0.27, 95% CI: 0.15 - 0.48, p < 0.001).
Conclusion: Analgo-sedation use is associated with prolonged ICU stays due to a significantly higher risk of adverse drug events, and treatment outcomes are associated with sedation protocols and patients' pre-existing medical conditions.

Sedative-analgesics use in Intensive Care: A Critical analysis of prescribed analgo-sedatives, treatment outcomes, and adverse drug events in adult patients at Komfo Anokye Teaching Hospital

Analgo-sedatives use in ICU of Komfo Anokye Teaching Hospital

Abstract