Analgesia e sedação

Rev Bras Anestesiol
2010; 60: 6: 648-658

REVIEW ARTICLE

REVIEW ARTICLE

Analgesia and Sedation in Intensive Care Unit
Rioko Kimiko Sakata, TSA 1

Summary: Sakata RK – Analgesia and Sedation in Intensive Care Unit.
Background and objectives: Many Intensive Care Unit (ICU) patients present pain. The administration of analgesics and sedatives is crucial for patient comfort and to reduce stress, as well as to prevent delay in recovery and ventilator weaning. The objective of the present study was to conduct a review on analgesia and sedation in the ICU.
Content: The present study reviewed the causes of pain, the methods used to evaluate the intensity of pain and sedation and the conducts employed in pain treatment and sedation. Drug selection is important in order to prevent excessive sedation, by performing analgesia before the sedation. Conclusions: The most commonly employed drugs are morphine, fentanyl, midazolam and propofol. Other medications are less frequently used.
Keywords: ANALGESIA; SEDATION; INTENSIVE THERAPY.
[Rev Bras Anestesiol 2010;60(6): 648-658] ©Elsevier Editora Ltda.

INTRODUCTION

Critically-ill patients

Most patients at the Intensive Care Unit (ICU) experience pain, fear and anxiety 1,2. The administration of analgesics and sedatives is crucial for patient comfort and to reduce stress, as well as to prevent delay in recovery and ventilator weaning1.
One study showed that less than 50% of the patients have adequate pain control at the ICU 3. The barriers were: the physician’s conduct, use of protocols without evidence, the professionals’ resistance in changing the conduct, inadequate method of assessment and insufficient training of the professionals regarding pain assessment and treatment.
Pain relief is essential for the patient’s adequate recovery
1,2,4,5. The benefit is more evident in the patient that presents alterations in several organs when the pain causes more severe alterations.
Recovery is