title: Sedation and Analgesia in Pediatric Cardiac Critical Care.
abstract: This review will focus on the pharmacokinetics (with an emphasis on the context-sensitive half-time), pharmacodynamics, and hemodynamic characteristics of the most commonly used sedative/hypnotic, analgesic, and IV anesthetics used in cardiac intensive care. In addition, the assessment of pain and agitation and withdrawal will be reviewed.
  
  
  
  MEDLINE, PubMed.
  
  
  
  Children in the cardiac ICU often require one or more components of general anesthesia: analgesia, amnesia (sedation and hypnosis), and muscle relaxation to facilitate mechanical ventilation, to manage postoperative pain, to perform necessary procedures, and to alleviate fear and anxiety. Furthermore, these same children are often vulnerable to hemodynamic instability due to unique underlying physiologic vulnerabilities. An assessment of hemodynamic goals, postoperative procedures to be performed, physiologic vulnerabilities, and the intended duration of mechanical ventilation should be made. Based on this assessment, the optimal selection of sedatives, analgesics, and if necessary, muscle relaxants can then be made.
authors.affiliation: Both authors: Division of Cardiac Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA.
authors.forename: Viviane G
authors.initials: VG
authors.lastname: Nasr
authors.forename: James A
authors.initials: JA
authors.lastname: DiNardo
mesh_terms: D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use; D000758:Anesthesia / Q000379:methods*; D002648:Child; D003422:Critical Care / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D015278:Intensive Care Units, Pediatric; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives