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镇静和镇痛药物:危重症患者谵妄和睡眠障碍的危险因素。

Sedative and analgesic medications: risk factors for delirium and sleep disturbances in the critically ill.

作者信息

Pandharipande Pratik, Ely E Wesley

机构信息

Division of Critical Care, Department of Anesthesiology, Vanderbilt University School of Medicine, 324 MAB, 1313 21st Avenue South, Nashville, TN 37232, USA.

出版信息

Crit Care Clin. 2006 Apr;22(2):313-27, vii. doi: 10.1016/j.ccc.2006.02.010.

Abstract

Sedatives and analgesics are routinely used in critically ill patients, although they have the potential for side effects, such as delirium and sleep architecture disruption. Although it should be emphasized that these medications are extremely important in providing patient comfort, health care professionals must also strive to achieve the right balance of sedative and analgesic administration through greater focus on reducing unnecessary or overzealous use. Ongoing clinical trials should help us to understand whether altering the delivery strategy, via daily sedation interruption, or protocolized target-based sedation or changing sedation paradigms to target different central nervous system receptors can affect cognitive outcomes and sleep preservation in our critically ill patients.

摘要

镇静剂和镇痛药在重症患者中经常使用,尽管它们有可能产生副作用,如谵妄和睡眠结构紊乱。尽管应该强调这些药物在为患者提供舒适方面极其重要,但医疗保健专业人员也必须通过更加注重减少不必要或过度使用来努力实现镇静和镇痛药物给药的正确平衡。正在进行的临床试验应有助于我们了解,通过每日中断镇静、基于目标的程序化镇静或改变镇静模式以针对不同的中枢神经系统受体来改变给药策略,是否会影响重症患者的认知结果和睡眠维持。

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