الفهرس 
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Abstract
Summary
Critically ill patients in an intensive care unit (ICU) are subjected to a variety of noxious stimuli including pain after surgery ,frequent venipuncture , invasive monitoring and endotracheal intubation (1) .
drugs used for sedation
The ’Ideal Sedative Agent’ should possess the following qualities:
● Sedative, analgesic and anxiolytic properties
● Minimal cardiovascular and respiratory side-effects
● Rapid onset and offset of action
● No accumulation in renal/hepatic dysfunction
●Inactive metabolites
● No interactions with other drugs (98) .
according to Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit suggested that sedation strategies using nonbenzodiazepine sedatives (either propofol or dexmedetomidine) may be preferred over sedation with benzodiazepines (either midazolam or lorazepam) to improve clinical outcomes in mechanically ventilated adult ICU patients(172)
In this study;ketofol ,dexmedetomidine ,and propofol were used for sedation of intubated and mechanically ventilated patients in the surgical ICU .Their safety and efficacy were evaluated and compared. The main finding of the current study was that, infusion of of ketofol, dexmedetomidine or propofol was effective in maintaining Ramsay Sedation Scale in the range of 2-4 for the patients who were sedated by ketofol or dexmedetomidine and 2-5 for the patients who were sedated by propofol without causing hemodynamic instability.