ABSTRACT
OBJECTIVES@#To investigate the effect of sequential sedative and analgesic drugs in preventing delirium and withdrawal symptoms in children after ventilator weaning.@*METHODS@#A retrospective analysis was performed on 61 children who were admitted and received mechanical ventilation support for ≥5 days in the Pediatric Intensive Care Unit of Dongguan Children's Hospital Affiliated to Guangdong Medical University from December 2019 to September 2021. The children were divided into a control group (30 children with no maintenance of analgesic and sedative drugs after ventilator weaning) and an observation group (31 children with sequential sedative and analgesic drugs maintained for 48 hours after ventilator weaning). The two groups were compared in terms of the Sophia Observation Withdrawal Symptoms Scale (SOS) score, the Pediatric Delirium Scale (PD) score, the Richmond Agitation-Sedation Scale (RASS) score, and the incidence rates of delirium or withdrawal symptoms at 24 and 72 hours after ventilator weaning.@*RESULTS@#There was no significant difference in the incidence rate of delirium at 24 hours and 72 hours after ventilator weaning between the two groups (P>0.05). Compared with the control group, the observation group had significantly lower incidence rate of withdrawal symptoms and scores of SOS, PD, and RASS scales at 24 hours and 72 hours after ventilator weaning (P<0.01).@*CONCLUSIONS@#Sequential sedation and analgesia after ventilator weaning can reduce the incidence of withdrawal symptoms within 72 hours after ventilator weaning, but it cannot reduce the incidence rate of delirium.
Subject(s)
Child , Humans , Analgesia , Analgesics/therapeutic use , Delirium/prevention & control , Hypnotics and Sedatives/therapeutic use , Intensive Care Units, Pediatric , Pain , Prospective Studies , Respiration, Artificial/adverse effects , Retrospective Studies , Substance Withdrawal Syndrome/prevention & control , Ventilator WeaningABSTRACT
Analgesia and sedation are important for children with acute critical diseases.With the new development of the concept of analgesia and sedation, new analgesics and sedatives are constantly introduced.Remifentanil has the characteristics of short half-life, no accumulation, less impact on important organs of patients, better controllability, better analgesic effect and quick onset, and has been widely used in children with critical diseases.This paper discussed the application advantages of remifentanil in children with critical diseases.
ABSTRACT
Effective analgesia and sedation is important for critically ill patients. .It aims to eliminate or relieve pain, anxiety and agitation during intensive care and at the same time help to reduce the host stress response and inflammation, decrease oxygen exhaustion and demand, and protect organ function and enhances recovery. The principle of analgesia and sedation is to give priority to analgesia, minimize sedation, and patient-centered humanistic care to ensure the smooth progress of intensive treatment, and reduce stress response and medically related secondary damage. To achieve enhanced rehabilitation in critically ill patients, we proposed three aspects for optimum analgesia and sedation. Firstly, target-based analgesia and sedation protocol is imperative for achieving effective analgesia and sedation, and also it is important to avoid adverse effects caused by over use of drugs. Secondly, multi-modal analgesia is preferable to maximize the analgesia while being able to limit the dose and thereby side effects of opioids, such as inhibition of respiratory system and bowl movement. At last, prevention and management of acquired delirium is helpful for early initiation of physical exercise and improvement of short- and long-term cognition function.
ABSTRACT
Analgesia and sedation is the necessary measure in critically ill patients. For implementation of an-algesia and sedation treatment, we should respect the patients′ and family members′rights to be informed. Under the premiseof profit maximization and priority to life,we should optimize the analgesic and sedative treatment, and avoid the adverse effects and complications as far as possible. At the same time, we should pay attention to protec-ting patients′privacy and strengthening the cooperation of physicians and nurses. Analgesia sedation management mode formulated and guided by physicians and nurses-led should be promoted.
ABSTRACT
Nitrous oxide/oxygen is one of the inhaled anesthetics that receives attention by scholars at home and abroad for its unique characteristics of excellence comparing with intravenous sedation analgesia which is more commonly used. In addition, the nurses who are the main body personnels of the pain management have certain differences in the implementation of the nitrous oxide/oxygen sedation analgesia both at home and abroad. In this paper, the nitrous oxide/oxygen analgesia and sedation and its nursing implications were reviewed from the physical and chemical properties, pharmacokinetic characteristics, excellent properties, mechanism of action and clinical application, then development directions of management in the future are put forwarded so as to provide theoretical evidences and practical guidelines for domestic medical staffs cooperating to implement the technology.
ABSTRACT
Critically ill children suffer from pain and anxiety additionally in the face of severe organ dysfunction and often require analgesia and sedation.Different medications and combinations of medications can be used to achieve the desired effect.It is also important to keep in mind the possible adverse reactions and side effects associated with each medication.The side effect of the medications often used in children and prevention and therapy of common complications associated with analgesia and sedation is reviewed.