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Analgesia and Sedation

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7 papers 0 to 25 followers
By MD Aware Emergency Medicine
Diederik Gommers, Jan Bakker
Critically ill patients are often treated with continuous intravenous infusions of sedative drugs. However, this is associated with high risk for over-sedation, which can result in prolonged stay in the intensive care unit. Recently introduced protocols (daily interruption and analgosedation) have proven to reduce the length of intensive care unit stay. To introduce these protocols, new agents or new regimens with the well established agents may be required. In this article we briefly discuss these new regimens and new agents, focusing on the short-acting substances...
2008: Critical Care: the Official Journal of the Critical Care Forum
I Rundshagen, K Schnabel, C Wegner, SchulteJ am Esch
OBJECTIVE: To define the incidence of recall and dreams during analgosedation in critically ill patients. DESIGN: Prospective clinical study. SETTING: Anaesthesiological intensive care unit (ICU) in a university hospital. PATIENTS AND PARTICIPANTS: Two hundred and eighty-nine critically ill patients, who either arrived intubated and sedated at the ICU or required intubation, mechanical ventilation, and sedation during their ICU stay...
January 2002: Intensive Care Medicine
Brian L Erstad, Asad E Patanwala
PURPOSE: The purpose of this narrative review is to provide practical and useful guidance for clinicians considering the use of intravenous ketamine for its analgosedative properties in adult, critically ill patients. METHODS: MEDLINE was searched from inception until January 2016. Articles related to the pharmacological properties of ketamine were retrieved. Information pertaining to pharmacology, pharmacokinetics, dosing regimens, adverse effects, and outcomes was obtained from relevant studies...
October 2016: Journal of Critical Care
Kristen M Tedders, Kelly N McNorton, Stephanie B Edwin
OBJECTIVES: To compare the efficacy and safety of analgosedation with fentanyl versus traditional sedation with propofol in critically ill patients receiving mechanical ventilation. METHODS: Retrospective, observational study evaluating adult critically ill patients on mechanical ventilation at a community teaching hospital who received continuous infusion fentanyl (n=50) or propofol (n=50) from September 2011-March 2013. RESULTS: Median duration of mechanical ventilation was similar between patients receiving propofol and fentanyl infusions (46...
June 2014: Pharmacotherapy
Xavier Basurto Ona, Dimelza Osorio, Xavier Bonfill Cosp
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 8, 2011, on 'Drug therapy for treating post-dural puncture headache'.Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture, an invasive procedure frequently performed in the emergency room. Numerous pharmaceutical drugs have been proposed to treat PDPH but there are still some uncertainties about their clinical effectiveness. OBJECTIVES: To assess the effectiveness and safety of drugs for treating PDPH in adults and children...
July 15, 2015: Cochrane Database of Systematic Reviews
Takeshi Matsumoto, Keisuke Tomii, Ryo Tachikawa, Kojiro Otsuka, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Michiaki Mishima, Kazuo Chin
BACKGROUND: Although sedation is often required for agitated patients undergoing noninvasive ventilation (NIV), reports on its practical use have been few. This study aimed to evaluate the efficacy and safety of sedation for agitated patients undergoing NIV in clinical practice in a single hospital. METHODS: We retrospectively reviewed sedated patients who received NIV due to acute respiratory failure from May 2007 to May 2012. Sedation level was controlled according to the Richmond Agitation Sedation Scale (RASS)...
July 13, 2015: BMC Pulmonary Medicine
Francesca L Beaudoin, Charlie Lin, Wentao Guan, Roland C Merchant
OBJECTIVES: Low-dose ketamine has been used perioperatively for pain control and may be a useful adjunct to intravenous (IV) opioids in the control of acute pain in the emergency department (ED). The aim of this study was to determine the effectiveness of low-dose ketamine as an adjunct to morphine versus standard care with morphine alone for the treatment of acute moderate to severe pain among ED patients. METHODS: A double-blind, randomized, placebo-controlled trial with three study groups was conducted at a large, urban academic ED over a 10-month period...
November 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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