Vilela Hugo, Ferreira Daniel
Serviço de Cardiologia, Hospital Fernando Fonseca Amadora, Portugal.
Rev Port Cardiol. 2006 Jan;25(1):89-98.
This article reviews relevant clinical issues regarding sedation, analgesia and neuromuscular blockade in the cardiac intensive care unit, including monitoring tools and available therapeutic options. The pathophysiologic implications of pain, agitation, anxiety and delirium in the ventilated patient are also discussed. Although guidelines for sedation, analgesia and neuromuscular blocking drugs in critical care have recently been published, there is great variability in clinical practice. The complexity of the environment and associated pathologies makes it difficult to implement universally applicable therapeutic regimens. Knowledge of pharmacologic mechanisms is an important tool in the development of dynamic protocols adapted to each unit. Strategies that include monitoring resources are essential for the optimization of sedation, analgesia and neuromuscular blockade.
本文回顾了心脏重症监护病房中有关镇静、镇痛和神经肌肉阻滞的相关临床问题，包括监测工具和可用的治疗选择。还讨论了通气患者疼痛、躁动、焦虑和谵妄的病理生理影响。尽管最近已经发布了重症监护中镇静、镇痛和神经肌肉阻滞药物的指南，但临床实践中仍存在很大差异。环境和相关病症的复杂性使得难以实施普遍适用的治疗方案。了解药理机制是制定适用于每个病房的动态方案的重要工具。包括监测资源在内的策略对于优化镇静、镇痛和神经肌肉阻滞至关重要。
