Sedation and Analgesia in the ICU

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Sedation

Sedation and analgesia have high importance in patient-centered care. Patients in the ICU are seriously ill and often suffer from anxiety, agitation, and pain.

There is sometimes a need to use deep and prolonged sedation, but that can cause other issues which need to be addressed.

When deep sedation is used, the patient becomes immobile. This can lead to ICU acquired weakness as well as delirium due to the immobilization of the brain function.

Deep and prolonged sedation is associated with worse outcomes, longer duration of mechanical ventilation (MV), longer length of stay (LOS) in the ICU and the hospital, and higher rates of complications such as infections and sometimes even death.

Hence it is very important to limit the use of deep and prolonged sedation and to understand the use of sedation and pain targets.

Thanks to adequate control of the pain, the level of sedation can be reduced. But if the pain is not controlled properly, there is a risk of increased agitation. So, it is very important to use valid and robust tools to assess for agitation such as the Richmond Agitation Sedation Scale (RASS).

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