Sedation and Analgesia

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Author(s): Jordan Brand (San Francisco VA Medical Center, USA & University of California – San Francisco, USA)
Copyright: 2015
Pages: 35
Source title: Modern Concepts and Practices in Cardiothoracic Critical Care
Source Author(s)/Editor(s): Adam S. Evans (Icahn School of Medicine at Mount Sinai, USA), Gregory E. Kerr (Weill Cornell Medical College, USA), Insung Chung (Icahn School of Medicine at Mount Sinai, USA)and Robin Varghese (Icahn School of Medicine at Mount Sinai, USA)
DOI: 10.4018/978-1-4666-8603-8.ch012

Keywords: Cardiovascular Medicine / Medical Diagnosis and Practice / Medical Information Science Reference / Medicine & Healthcare

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Abstract

Patients in the cardiothoracic intensive care unit (CTICU) are subject to numerous physical and mental stresses. While most of these cannot be completely eliminated, intensivists have many tools in their armamentarium to alleviate patients' pain and suffering. This chapter will consider the importance of analgesia and sedation in the CTICU and the relevant consequences of over- or under-treatment. We will examine the tools available for monitoring and titrating analgesia and sedation in critically ill patients. The major classes of medications available will be reviewed, with particular attention to their clinical effects, metabolism and excretion, and hemodynamic characteristics. Lastly, experimental evidence will be assessed regarding the best strategies for treatment of pain and agitation in the CTICU, including use of non-pharmacologic adjuvants.

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