Sedation and analgesia in the critically ill adult.
OBJECTIVE
To review the recent advances in providing analgesia and sedation to intensive care unit patients that can improve outcomes, and reduce resource utilization and adverse events.


RESULTS
Validated tools to assess patient sedation and analgesia are available, and have been shown to improve outcomes when used. A strategy providing analgesia-first and supplemented by sedation-as-needed appears to improve patient outcomes. The negative impact of deep sedation to the point of coma, even for brief periods, is again recognized. Additional data defining adverse events associated with propofol and lorazepam can help us develop strategies to avoid them.


CONCLUSIONS
Utilizing and incorporating these new advances can improve outcomes and result in a more comfortable patient.
Fraser
Gilles L
GL
Division of Pulmonary and Critical Care Medicine, Maine Medical Center, Portland, ME 04102, USA. fraseg@mmc.org
Riker
Richard R
RR
D000328:Adult; D000698:Analgesia / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D003422:Critical Care / Q000379:methods* / Q000639:trends; D016638:Critical Illness; D006801:Humans