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    Because of these additive effects, these medications taken with other sedatives or alcohol (also a sedative hypnotic drug) may increase chances for accidental death.In general, most of the medications that induce sedation may alter breathing and cardiac stability.This changed after 48 hours with 34% of patients being deeply sedated and 62,4% lightly sedated.The incidence of delirium was 44% and the most commonly used agents for sedation and analgesia were midazolam and morphine.Because of their toxicity, bromides were replaced by barbiturates in the early 20th century, which were initially also heralded as effective and safe sedative drugs.However, in a short period of time problems with dependence, tolerance and lethal overdosing became evident.Despite the fact that sedation plays a central role in intensive care medicine, there are important aspects which have not yet been fully studied.

    We have developed a nurse-led sedation service that is successful in 95% of selected children,1 but involves high doses of sedatives which risks both excessive sedation during the scan and prolonged recovery. If necessary, further ‘top-up’ sedation was administered 15 min after chloral or 40 min after temazepam and droperidol had been given, or if the child awakened later during the scan. Melatonin may induce a natural sleepiness and improve predictability of sedation drugs.We have investigated its clinical value in children sedated for magnetic resonance imaging. In a stratified randomized double-blind study, 98 children received either melatonin or placebo 10 min before they were sedated with a standard oral regimen.Attempts to find sedatives other than alcohol for treating anxiety and nervousness began in the 19th century with the introduction of bromides, which were discovered in 1826.These drugs were extremely popular for this purpose until their propensity to build up in the body and produce toxic effects became known in the medical community.

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