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2 results

  • Chapter 29 - Endocrine disorders
  • from Section 4 - The pregnant patient with coexisting disease
  • Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
  • Book: Maternal Critical Care
  • Published online: 05 July 2013
  • Print publication: 04 July 2013, pp 322-334
  • View abstract

    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.