Studying the effect of intravenous chlorpromazine injection to reduce the use of sedative drugs in patients under ventilation

Abstract

Introduction: This study aimed to evaluate the sedation efficacy and drug requirements between the two groups.

Method: This randomized, double-blind clinical trial involved 50 ICU patients, divided into chlorpromazine and control groups. Both groups initially received fentanyl (1.5 mcg/kg) and midazolam (2 mg) bolus injections, with time recorded. The chlorpromazine group additionally received 50 mg intramuscular chlorpromazine by a blinded administrator. Sedation levels were assessed hourly up to 4 hours using the Richmond Agitation-Sedation Scale (RASS).

Result: According to the table above, the frequency distribution of sedative drug injections after the initial dose in patients indicates that in the control group, 86% of the subjects had two and three injections, respectively, while in the chlorpromazine group, only 24% of the subjects had two injections and no patient had three injections. With the intramuscular injection of chlorpromazine, there was no change in blood pressure in the short term (time 1). Nevertheless, after a longer time (time 4), a significant difference was observed between the blood pressure of the two groups. This pattern could indicate a strong and long-term effect of the drug.

Conclusion: intravenous chlorpromazine at usual doses can be used effectively and with acceptable safety as a treatment option for controlling agitation in adult patients hospitalized in the ICU.