Sedation and Analgesia for Critically Ill Patients

Sedation in critically ill patients is principally used to control agitation, allow mechanical ventilation free of dyssynchrony, and provide analgesia.  These goals are quite distinct from the goals of anaesthesia, which are to provide short-term analgesia, sleep, and muscle relaxation to facilitate surgery.  The point of distinction between intensive care sedation and anaesthesia is the primary goal of intensive care sedation is to prevent agitation; in anaesthesia, it is to produce sedation.  Specifically, different goals of treatment necessitate different methods of titration.


The Christchurch Intensive Care unit has developed a semi-automated sedation interface, the Infuserite.  This device allows nurses to rapidly control sedation using bolus sedation, while a variable background infusion is automatically delivered according to the amount of sedation given for agitation as extra boluses.  When the patient is settled and is no longer requiring extra bolus sedation, the background infusion rate is reduced.  The background rate is updated every thirty minutes and set to two thirds of the average hourly total dose given over the previous two hours.


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Page last reviewed: 14 May 2014