Assessment of sedation, analgesia, and neuromuscular blockade in the perioperative period.
Identification of adequate pain relief, sedation, and neuromuscular blockade in the perioperative period (be it for monitored anesthesia care, conscious sedation, ICU analgesia or sedation, or during intraoperative care) continues to be a challenge. Current subjective and objective techniques have been reviewed. The combination of clinical judgement, physiological response, and selected monitoring tools provide the current standard of care used to optimize patient care and comfort. Future directions in assessing pain control, adequacy of sedation, and degree of neuromuscular blockade include: (1) simplified scoring scales, (2) computerized analysis of the EEG, (3) computerized evoked potentials, (4) portable accelerography of electromyography for determination of neuromuscular blockade, and (5) closed loop system for delivery of analgesics, sedatives, and paralytics.
Department of Anesthesiology, University of Wisconsin Medical School, Madison, USA.
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D000698:Analgesia; D000700:Analgesics / Q000008:administration & dosage; D016292:Procedural Sedation; D003422:Critical Care; D016503:Drug Delivery Systems; D004569:Electroencephalography; D004576:Electromyography; D005071:Evoked Potentials / Q000502:physiology; D005544:Forecasting; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D016343:Monitoring, Intraoperative; D008991:Monitoring, Physiologic; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011182:Postoperative Care; D011300:Preoperative Care; D012815:Signal Processing, Computer-Assisted
D000700:Analgesics; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents