Motta Emiliana, Luglio Michele, Delgado Artur Figueiredo, Carvalho Werther Brunow de
Assistant Physician at the Pediatric Intensive Care Unit (PICU), Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil.
Clinical Preceptor at the PICU, Instituto da Criança, HC-FMUSP, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2016 Sep;62(6):602-609. doi: 10.1590/1806-9282.62.06.602.
: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols.
: Literature review on the main aspects of analgesia and sedation, abstinence syndrome, and delirium in the pediatric intensive care unit, in order to show the importance of the use of protocols on the management of critically ill patients.
: Articles published in the past 16 years on PubMed, Lilacs, and the Cochrane Library, with the terms analgesia, sedation, abstinence syndrome, mild sedation, daily interruption, and intensive care unit.
: Seventy-six articles considered relevant were selected to describe the importance of using a protocol of sedation and analgesia. They recommended mild sedation and the use of assessment scales, daily interruptions, and spontaneous breathing test. These measures shorten the time of mechanical ventilation, as well as length of hospital stay, and help to control abstinence and delirium, without increasing the risk of morbidity and morbidity.
: Despite the lack of controlled and randomized clinical trials in the pediatric setting, the use of protocols, optimizing mild sedation, leads to decreased morbidity.
镇痛和镇静是重症监护病房（ICU）患者护理的重要组成部分，目的是促进疼痛、焦虑和躁动的控制，防止设备丢失、意外拔管，并提高患者与机械通气的同步性。然而，这些药物使用过量会导致发病率和死亡率上升。理想的管理方式将取决于在量表和方案的指导下采取临床和药理学措施。
对儿科重症监护病房中镇痛、镇静、戒断综合征和谵妄的主要方面进行文献综述，以表明使用方案对危重症患者管理的重要性。
检索过去16年在PubMed、Lilacs和Cochrane图书馆发表的文章，检索词为镇痛、镇静、戒断综合征、轻度镇静、每日中断和重症监护病房。
选择了76篇相关文章来描述使用镇静和镇痛方案的重要性。它们推荐轻度镇静以及使用评估量表、每日中断和自主呼吸试验。这些措施缩短了机械通气时间以及住院时间，并有助于控制戒断和谵妄，而不会增加发病率和死亡率风险。
尽管儿科领域缺乏对照和随机临床试验，但使用方案优化轻度镇静可降低发病率。
