Analgosedation: Improving Patient Outcomes in ICU Sedation and Pain Management.
Sedation practices in the critical care unit have been trending toward lighter sedation since the start of the new millennium, but patients continue to experience inadequate pain management and excessive sedation. This paper includes a brief examination of the problem of pain management in the ICU; trends in sedation practices, including light sedation and the daily interruption of sedation; and a literature review of analgosedation. While the analgosedation literature is relatively sparse, it offers a promising, patient-centered method for managing the triad of pain, agitation, and delirium, while reducing common complications associated with long-term ventilation. This paper concludes with a recommended method for analgosedation, the nursing implications, and a discussion of limitations and recommendations.
Georgetown University School of Nursing and Health Studies, Washington, D.C.
Ryan
R
Wiatrowski
Georgetown University School of Nursing and Health Studies, Washington, D.C.. Electronic address: nortonc@georgetown.edu.
Colleen
C
Norton
Georgetown University School of Nursing and Health Studies, Washington, D.C.
David
D
Giffen
D000700:Analgesics / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003142:Communication; D003693:Delirium / Q000209:etiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007362:Intensive Care Units / Q000191:economics / Q000458:organization & administration; D009020:Morphine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods*; D063868:Patient Outcome Assessment; D010880:Piperidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D011595:Psychomotor Agitation / Q000209:etiology; D000077208:Remifentanil; D012121:Respiration, Artificial / Q000379:methods / Q000451:nursing
D000700:Analgesics; D006993:Hypnotics and Sedatives; D010880:Piperidines; D009020:Morphine; D000077208:Remifentanil