Abstract: Objective To analyze the current application status, research hotspots and development trends of sedation strategies from both domestic and international perspectives in mechanically ventilated patients in the intensive care unit (ICU). Methods Relevant literature on the application of sedation strategies in mechanically ventilated patients from 2014 to 2024 was retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang and Web of Science. Visual analysis of publication volume and keywords was conducted using CiteSpace 6.2. R3 software. Results A total of 475 Chinese-language articles and 405 English-language articles were included. Significant differences were observed in publication volume between domestic and international research, with early domestic activity followed by a decline, while international research had demonstrated robust and sustained growth over the past five years. International studies primarily emphasized protocol-driven sedation processes and standardized strategies, whereas domestic research focused on optimizing the concept of comfort-oriented sedation management and exploring postoperative sedation strategies. Analysis of research hotspots revealed that precise pharmacological regulation, the development of disease-specific sedation strategies, and the establishment of multidisciplinary collaborative protocols were key areas of focus in sedation strategies for ICU mechanically ventilated patients. Conclusion Future research should prioritize shortening the update cycle of clinical guidelines, enhancing the translation of evidence-based practices into clinical settings, establishing clear application standards for disease-specific sedation strategies, improving multicenter collaborative research capabilities, and developing artificial intelligence-based sedation monitoring technologies.