Clinical trial of continuous infusion of alphaxalone/alphadolone in intensive care patients.

The safety and efficacy of prolonged infusion of alphaxalone/alphadolone (Alfathesin: Glaxo) was assessed in 20 critically ill patients needing sedation during intermittent positive pressure ventilation in a general intensive care unit. The mean dose of Alfathesin infused was 1542 ml (range: 225 to 4820 ml) over 6.9 days (3 to 16 days) at rates between 5 and 15 ml/hour. Significant increases in plasma urea, creatinine, bilirubin, alkaline phosphatase and white cell count occurred during the infusion, but these were expected from each patient's clinical course. Lipoprotein electrophoresis invariably showed loss of the alpha band and appearance of a densely staining pre-beta band. Four patients had involuntary movements during the infusion and two patients fitted when the infusion stopped. Both had cerebral injuries. Subjective assessment of the quality of sedation was "very good" or "good" in 15 patients and "fair" in five.