Abstract
Sedation plays an important role in managing patient care in the ICU. Adequate control of sedation depth is associated with outcomes, including duration of mechanical ventilation and ICU length of stay. Therefore, assessment tools for depth of sedation should have enough reliability, validity, and clinical usability. To date, subjective scales are most commonly used to assess the depth of sedation. The Ramsay Scale, Sedation-Agitation Scale (SAS), Motor Activity Assessment Scale (MAAS), and Richmond Agitation-Sedation Scale (RASS) are frequently used for adult patients. In the present review, we clarify the most useful scale from those discussed in the literature. The Ramsay Scale, the oldest scale (developed in 1974), is frequently used around the world, however, assessment for level of agitation is limited. Reliability and validity of SAS and MAAS have been evaluated, however, their evaluation did not cover all aspects of validity in different populations. In contrast, validity and reliability of RASS has been more evaluated than other scales, and suggests that RASS has enough validity and reliability for clinical use. Thus, to date, RASS is the most useful scale for assessment of depth of sedation in adult ICU patients among the sedation scales.
