Valdivielso-Serna A
Servicio de Cuidados Intensivos Pediátricos, Hospital del Niño Jesús, Madrid, España.
Med Intensiva. 2008 Feb;32 Spec No. 1:115-24.
The basic concepts of sedation and analgesia and the tools to asses the level of sedation and analgesia are review. The different methods of sedation and the non pharmacological interventions are described. Sedatives, analgesics and muscle relaxants, their pharmacodynamics and pharmacokinetics in children, their indications in specific situations (intubation, pain control, sedation and neuromuscular blocking) are reviewed. The etiology of patient-ventilator asynchrony in ventilated children and how to treat it are analyzed, giving guides of how to adapt sedation to the level of mechanical ventilation therapy. Finally, general recommendations are given for the analgesia and sedation in mechanically ventilated children.
本文回顾了镇静和镇痛的基本概念以及评估镇静和镇痛水平的工具。描述了不同的镇静方法和非药物干预措施。综述了镇静剂、镇痛药和肌肉松弛剂在儿童中的药效学和药代动力学、它们在特定情况下(插管、疼痛控制、镇静和神经肌肉阻滞)的适应症。分析了机械通气儿童患者与呼吸机不同步的病因及治疗方法,给出了如何根据机械通气治疗水平调整镇静的指南。最后,给出了机械通气儿童镇痛和镇静的一般建议。