Department of Pharmaceutical and Nutrition Care, University of Nebraska Medical Center, Omaha, NE 68198-1090, USA.
Crit Care Med. 2013 Sep;41(9 Suppl 1):S46-56. doi: 10.1097/CCM.0b013e3182a168f5.
The management of pain, agitation, and delirium in critically ill patients can be complicated by multiple factors. Decisions to administer opioids, sedatives, and antipsychotic medications are frequently driven by a desire to facilitate patients' comfort and their tolerance of invasive procedures or other interventions within the ICU. Despite accumulating evidence supporting new strategies to optimize pain, sedation, and delirium practices in the ICU, many critical care practitioners continue to embrace false perceptions regarding appropriate management in these critically ill patients. This article explores these perceptions in more detail and offers new evidence-based strategies to help critical care practitioners better manage sedation and delirium, particularly in ICU patients.
在危重病患者中，疼痛、躁动和谵妄的管理可能会受到多种因素的影响。给予阿片类药物、镇静剂和抗精神病药物的决定通常是为了使患者感到舒适，并使他们能够耐受 ICU 内的侵入性操作或其他干预措施。尽管有越来越多的证据支持新策略来优化 ICU 中的疼痛、镇静和谵妄实践，但许多重症监护医生仍然对这些危重患者的适当管理存在错误的认识。本文更详细地探讨了这些看法，并提供了新的基于证据的策略，以帮助重症监护医生更好地管理镇静和谵妄，特别是在 ICU 患者中。
