Martin C, Potié F, Vialet R, Denis J P
Service de Réanimation et Centre de Traumatologie, Hôpital Nord, Marseille.
Presse Med. 1996 Oct 19;25(31):1479-90.
Sedation is a technique widely used in intensive care unit patients. The main objective is to ensure a proper level of analgesia and the best physical and psychical comfort possible. For the vast majority of patients a light level of sedation is adequate and the level of sedation can easily be deepened to perform a short but painful procedure. A deeper level of sedation, close to that of a general anesthesia is rarely needed and limited to specific indications: adult respiratory distress syndrome, head trauma, status asthmaticus. Drugs used for sedation are combinations of opioids (fentanyl or sufentanil), benzodiazepines (midazolam) and hypnotic drugs such as propofol. In combination with the pharmacological approach, a psychological approach is of greater interest in conscious patients.
镇静是一种在重症监护病房患者中广泛使用的技术。主要目的是确保适当的镇痛水平以及尽可能达到最佳的身心舒适度。对于绝大多数患者来说,轻度镇静就足够了,并且在进行简短但痛苦的操作时,镇静水平可以很容易地加深。很少需要接近全身麻醉的深度镇静,且仅限于特定指征:成人呼吸窘迫综合征、头部创伤、哮喘持续状态。用于镇静的药物是阿片类药物(芬太尼或舒芬太尼)、苯二氮䓬类药物(咪达唑仑)和催眠药物如丙泊酚的组合。与药物治疗方法相结合,心理治疗方法对清醒患者更有意义。