Analgesia and sedation in the intensive care unit: an overview of the issues.
Analgesic and sedative medications are widely used in intensive care units to achieve patient comfort and tolerance of the intensive care unit environment, and to eliminate pain, anxiety, delirium and other forms of distress. Surveys and prospective cohort studies have revealed wide variability in medication selection, monitoring using sedation scales, and implementation of structured treatment algorithms among practitioners in different countries and regions of the world. Successful management of analgesia and sedation incorporates a patient-based approach that includes detection and management of predisposing and causative factors, including delirium; monitoring using analgesia and sedation scales and other instruments; proper medication selection, with an emphasis on analgesia-based drugs; and incorporation of structured strategies that have been demonstrated to reduce likelihood of excessive or prolonged sedation.
Sessler
Curtis N
CN
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Virginia Commonwealth University Health System, Richmond, Virginia 23298, USA. csessler@vcu.edu
Wilhelm
Wolfram
W
D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D010147:Pain Measurement; D018802:Patient-Centered Care / Q000379:methods*
D000700:Analgesics; D006993:Hypnotics and Sedatives