Aim: Sedative and analgesic medications are among the most commonly used agents in the intensive care unit (ICU). This study aimed to evaluate sedation practices and examine associated clinical characteristics among critically ill patients admitted to a medical ICU.
Study Design: This single-center retrospective study was conducted in the medical intensive care unit of a tertiary education and research hospital in Istanbul, Türkiye. Adult patients admitted between March and August 2025 who received continuous sedative–analgesic infusions for at least 24 hours were included. Data were extracted from medical records. Sedation depth was assessed using the Richmond Agitation–Sedation Scale (RASS), and potential drug–drug interactions were evaluated.
Results: Forty-five patients (mean age, 60.0±17.4 years; 51.1% male) were included. Sedation was most commonly initiated to facilitate mechanical ventilation (68.9%). Dexmedetomidine and remifentanil were the most frequently used agents. The mean RASS score (-2.17±1.20) indicated a tendency toward moderate sedation. The median number of potential drug–drug interactions (Lexicomp category D or X) per patient was 2 (interquartile range, 0–4). Antipsychotic use (17.8%) was associated with a higher number of potential drug–drug interactions. ICU length of stay was positively correlated with the duration of mechanical ventilation (ρ=0.889, p<0.001), dexmedetomidine infusion (ρ=0.647, p<0.001), and remifentanil infusion (ρ=0.550, p=0.001).
Conclusions: Although sedative selection was largely consistent with current guideline recommendations, the findings indicate a tendency toward moderate sedation and polypharmacy. Continuous monitoring, structured assessment, and individualized dose titration are essential to optimize sedation quality and improve clinical outcomes in critically ill patients.