Critically ill patients receiving mechanical ventilation require analgesia and sedation.  At present, propofol remains the most widely used sedative for intubated/ventilated patients.  Recent trials have suggested that dexmedetomidine may reduce delirium and the duration of mechanical ventilation compared with other sedative medications.  In fact, recent SCCM guidelines suggest the use of dexmedetomidine over propofol in intubated patients.  In this podcast, we discuss a recent randomized trial that compared the effectiveness and safety of a dexmedetomidine-based sedation strategy with a propofol-based sedation strategy in mechanically ventilated critically ill patients.