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Chapter 19 - Sedation and pain management

from Section 3 - Special critical care tools and techniques

Published online by Cambridge University Press:  05 July 2013

Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

Analgesia and sedation are frequently used in intensive care unit (ICU) patients. Appropriate analgesia is of great importance in ICU patients. Fentanyl is the most frequently used drug for this purpose but can lead to a substantial overhang after prolonged administration. Remifentanil is a promising alternative with a stable context-sensitive half-life. Agitation is the most frequent reason to sedate the patient, and the drug of choice is usually midazolam. There is a growing trend to use propofol in ICU sedation. Propofol has the advantage of less accumulation and, therefore, has a more stable context-sensitive half-life. Although propofol seems to be an almost ideal sedative, there is concern about the propofol infusion syndrome. Volatile anesthetics are frequently used for anesthesia in pregnant patients. More recently, volatile anesthetics have also been used for sedation in the ICU.
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Maternal Critical Care
A Multidisciplinary Approach
, pp. 200 - 202
Publisher: Cambridge University Press
Print publication year: 2013

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