Sedation and analgesia in the intensive care unit

Abstract

Fear, anxiety and pain exarcerbate the stress response. Adequate level of sedation and control of pain attenuate the stress response and have been shown to decrease morbidity and mortality in the ICU.
Sedative agents are essential to modem intensive care but both drugs and an inappropriate level of sedation have adverse effects. Many agents are available and some approach an ideal, but none is perfect. A precise assessment of the level of sedation, the choice of the appropriate agent in a given situation is a challenge in many situations. The novel solution for the problem of sedation, analgesia and anxiolysis have been created: the new alpha-adrenergic agonist dexmedetomidine which induces a unique state of cooperative sedation and the ultrashort acting opiod remifentanyl that provides adequate analgesia without the risk for prolonged side effects after discontinuing therapy. Finally an older benzodiazepine, lorazepam is used when prolonged sedation is required.

Jurnalul Român de Anestezie Terapie intensivă 2002 Vol.9 Nr.2, 125-134

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Sedare şi analgezie în terapia intensivă