The concepts for good sedation include defining the range of sedation, the need for agents with rapid response that can be easily and rapidly varied in restless and confused patients, various modes of ventilation, continuous supervision and adequate monitoring. The benzodiazepines era brought diazepam, lorazepam, midazolam, but they are associated with delirium, whatever the drug or dose. Propofol has a better pharmacokinetic profile, but in most RCTs there was difference in time to extubation, and no difference in ICU discharge. Propofol infusion syndrome limits the use of propofol as the main agent for sedation in the ICU for more than two days or at a dose of more than 4mg/kg/h.

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