Department of Anesthesiology and Critical Care, Vanderbilt University School of Medicine, Nashville, TN 37212, USA.
Minerva Anestesiol. 2012 Mar;78(3):369-80.
Analgesics and sedatives are commonly prescribed in the ICU environment for patient comfort, however, recent studies have shown that these medications can themselves lead to adverse patient outcomes. Interventions that facilitate a total dose reduction in analgesic and sedative medications e.g. the use of nurse controlled protocol guided sedation, the combination of spontaneous awakening and breathing trials, and the use of short acting medications, are associated with improved outcomes such as decreased time of mechanical ventilation and ICU length of stay. This purpose of this review is to provide an overview of the pharmacology of commonly prescribed analgesics and sedatives, and to discuss the evidence regarding best prescribing practices of these medications, to facilitate early liberation from mechanical ventilation and to promote animation in critically ill patients.
镇痛药和镇静剂在 ICU 环境中常用于缓解患者的不适，但最近的研究表明，这些药物本身可能导致患者的不良预后。干预措施可以促进镇痛药和镇静剂的总剂量减少，例如使用护士控制的协议指导镇静、自发觉醒和呼吸试验的联合应用，以及使用短效药物，与改善结果相关，例如机械通气时间和 ICU 住院时间的减少。本综述的目的是提供常用镇痛药和镇静剂的药理学概述，并讨论这些药物的最佳处方实践的证据，以促进患者早日脱离机械通气并促进重症患者的苏醒。
