Intervention
death, pain
The degree of sedation was measured and recorded every 4 h using RASS. The Narcotrend Index (NI) value was continuously monitored at the same time using Narcotrend-Compact M (MT MonitorTechnik, Germany) and recorded every 4 h.The remifentanil infusion was started at an initial rate of 6.0 μg/kg/h and titrated to obtain adequate pain control. Patients allocated to the remimazolam group received remimazolam besylate (Yichang Humanwell Pharmaceutical Co., Ltd., China) intravenously at an initial infusion rate of 0.3 mg/kg/h and adjusted (maximum of 3.0 mg/kg/h) to achieve the desired level of sedation. Patients allocated to the propofol group received propofol (Fresenius Kabi China Co., Ltd.) intravenously at an initial infusion rate of 3.0 mg/kg/h and adjusted (maximum of 12.0 mg/kg/h) to achieve the desired level of sedation. If deep sedation was not achieved at the maximum infusion rate, rescue sedation with midazolam was used. The study was continued until one of the following occurred first: 48 h after enrollment, no need for deep sedation, discharge from our ICU, death, or requested cessation by attending physicians or investigators. If a patient still required sedation after stopping the intervention, other sedatives were given at the discretion of attending physicians.