In recent days, two people in the news -- Israeli Prime Minister Ariel Sharon and West Virginia coal miner Randal McCloy Jr. -- underwent medically induced comas to help them recover from serious life-threatening conditions.
A drug-induced coma, better known as sedation in the medical field, is commonly used in medical, surgical and neurological intensive care units. It is also used when patients undergo major operations. The types of drugs that are used to produce such effects include anesthetics, benzodiazepines (which are often given to outpatients for anxiety) and opioids (pain medications). The dosages of these medications can be adjusted quickly to produce the desired level of consciousness in an individual patient.
Most often, doctors use drug-induced comas for patients on ventilators -- machines that take over the work of breathing. A tube is placed from the patient's mouth into the airway (a procedure called intubation). Intubation can be quite irritating and uncomfortable for patients, and therefore sedation is used to make the breathing tube more pleasant.
In a medical intensive care unit, the most frequent respiratory problems that lead to intubation include emphysema, heart failure and pneumonia. Other patients who receive sedation in the intensive care unit include those who have suffered strokes (they sometimes lose the ability to breathe on their own); patients withdrawing from alcohol who become combative; patients who have ingested toxins (they can't protect their airways); and patients with severe, life-threatening infections.
The length of time patients may require sedation varies, and it depends upon the underlying condition that led to the placing of the breathing tube.
For example, an otherwise healthy patient who is intubated for pneumonia may need only sedation and ventilatory support for a few days. But patients with severe underlying lung disease (such as emphysema) often require sedation and ventilatory support for weeks, and sometimes although rarely, months.