Purpose Of Review: Sedation and analgesia are important means of providing care for the critically ill patient.
Recent Findings: It is now clear that posttraumatic stress disorders resulting from an intensive care unit stay may be prevented by the right level of sedation. New drug developments but also recent findings in new ventilation strategies allow for a sedation management that is better tailored to an individual's need. Most importantly, regular definition of the appropriate level of sedation and analgesia as well as monitoring of the desired level will help to avoid over- and undersedation and may ultimately improve the outcome of the patient and reduce costs.
Summary: Sedation and analgesia are now regarded as an integral part of treatment on the intensive care unit instead of being an unpleasant but necessary and minor issue. The importance of monitoring the level of sedation and analgesia has only recently been realized. It remains to be shown that new management strategies including an evaluation of the patient, planned interventions and the choice of drugs will further improve the care for the critically ill.
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http://dx.doi.org/10.1097/00001503-200304000-00003 | DOI Listing |
Anaesth Crit Care Pain Med
January 2025
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada; Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada.
Background: Pharmacological sedation and analgesia are used to alleviate discomfort during awake medical procedures but can cause adverse effects like apnea and hypoxemia, increasing the need for airway management and prolonging recovery. Virtual reality (VR) has emerged as a non-pharmacological intervention to reduce the need for procedural sedatives and analgesics.
Methods: A systematic review and meta-analysis were conducted, assessing the impact of VR immersion on intraprocedural sedation and analgesia usage in adults (≥ 18 years).
J Int Med Res
January 2025
Department of Anesthesiology and Pain Medicine, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).
Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.
Nat Rev Cardiol
January 2025
Stanford Cardiovascular Institute, Stanford, CA, USA.
Cannabis has been consumed for centuries, but global regulatory changes over the past three decades have increased the availability and consumption of cannabis. Cannabinoids are touted to have therapeutic potential for many diseases and could be a replacement for opioids for analgesia and sedation. However, cannabinoids can cause substantial adverse cardiovascular events that would mitigate any potential benefit.
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January 2025
Department for Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Introduction: This study aimed to investigate the analgesic efficacy of perioperative electroacupuncture in fifty-six healthy female dogs undergoing ovariohysterectomy as part of a catch-neuter-release project.
Materials And Methods: Ten minutes after sedation with 20 μg/kg medetomidine combined with 0.3 mg/kg butorphanol intramuscularly, the dogs were randomly allocated into two groups and received either electroacupuncture (EA, = 27) or sham acupuncture (C, = 29) treatment for 10 min (after sedation until the end of the surgery) at 6 different acupuncture points LI-4 (Large intestine 4), LIV-3 (Liver 3), ST-36 (Stomach 36), SP-6 (Spleen 6) bilateral.
Med Sci Monit
January 2025
Department of Anesthesiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.
BACKGROUND Butorphanol, an opioid receptor agonist and antagonist, is widely used for post-cesarean section analgesia in the form of intravenous or intramuscular injection, but nasal sprays are less used. This study aimed to evaluate the analgesic effect of butorphanol nasal spray on uterine contraction pain after cesarean section and explore its effect on postpartum prolactin secretion. MATERIAL AND METHODS We randomly divided 120 patients scheduled for cesarean section into 3 groups (40 per group): intranasal saline (control), butorphanol intranasal (BI), and butorphanol pumped intravenously (BV).
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