The correct management of sedation is one of the most important aspects of Intensive Care management 1 . Some degree of sedation (i.e. analgesia ± hypnosis) is often required to allow patient co-operation with organ system support and the associated nursing care. 2 An agitated patient has a higher basal metabolic rate and may reduce the efficiency of supportive care, ventilator dysynchrony, increase in oxygen consumption, and inadvertent removal of devices and catheters. Here is an overview of

more »

... edation in ICU. INTRODUCTION: • Sedation comes from the Latin word sedare which means to calm or to allay fear. • Sedation is the process of establishing a state of calm. • Conscious sedation: A minimally depressed level of consciousness induced by the administration of pharmacologic agents in which a patient retains the ability to independently and continuously maintain an open airway and a regular breathing pattern, and to respond appropriately and rationally to physical stimulation and verbal commands. Why is sedation necessary? 2  To improve patient comfort  Facilitate interventions  To allay fear, anxiety and agitation  Adequate sleep  Avoid pain  Facilitation of mechanical ventilation/airway management/ weaning  Protection against myocardial ischemia  Amnesia during neuromuscular blockade Goals for sedation and analgesia  To minimize physical discomfort or pain during procedures  To minimize psychological disturbance  To maximize the potential for amnesia  To guard patient safety  To control behavior IDEAL SEDATIVE 3 : The ideal sedative agent should possess the following qualities: • Both sedative and analgesic • Minimal cardiovascular side effects REVIEW ARTICLE Hence adequate sedation is essential in ICU. therapeutic dose of analgesic and sedative drugs differs for each patient, so use the recommended drug doses as a starting point, and titrate the dose as needed until the patient is comfortable. Finally, when the patient begins to recover, start daily wake-up tests to prevent unwanted prolongation of drug effects.