Informative and target level-controlled
- Clinical Practice of Analgosedation
- Intravenous sedatives and analgetics
- Disadvantages of intravenous sedatives
- Benefits of inhalative sedation with VA
The terms analgosedation or sedoanalgesia designate a drug-induced so-called "twilight sleep". Ideally, the patient is in a painless state and feels neither stress nor fear.
The target of the analgosedation is therefore the calm, painless, cooperative and relaxed patient who shows no defensive movements against unpleasant manipulations yet breathes spontaneously and sufficiently and shows no or only slight cardiovascular reactions.
Accordingly, typical indications for analgosedation are rather unpleasant than painful procedures such as endoscopic examinations (colonoscopy, gastroscopy), dressing changes or also minor operations (dental operations, small plastic surgery etc.). Especially in operations, analgosedation is performed along with local anaesthesia to ensure safe freedom from pain.
For most patients an intensive care treatment is a decisive turning-point in their everyday life which may impose severe restrictions even months or years after the intensive care treatment. Surveys conducted with intensive care patients showed that the major part of the patients during the intensive care treatment suffer from
- and states of confusion.
Even months after intensive care patients so treated reported about states of confusion and disorientation.
For most ventilated patients the administration of sedating and/or analgesic drugs appears necessary simply to assure a sufficient tolerance of tubus and respirator. Not least pain, fear and stress lead to an increase of the demand of O2, increased cardio-circulatory load and possibly suppression of the immune system, which especially in ventilated patients with limited cardiopulmonary reserve and increased risk of infection has to be avoided by all means. For ventilated patients in intensive care therefore an adequate analgosedation is not only a commandment of humanity but also a medical necessity.
Adequate analgesia and sedation is therefore an essential component of any intensive care treatment, in addition to the wide range of invasive diagnostics and therapy. Without sedation and analgesia that is variably adapted to the needs of the patient, many of the necessary diagnostic, therapeutic and nursing measures could not be carried out at all.
Analgesia with pain caused by the underlying disease or by diagnostic, therapeutic and nursing measures induced by intensive-care treatment.
Anxiolytics for the reduction of the psychological stresses related with the trauma (injury, serious illness) and intensive care.
Sedation for shielding with necessary physically or mentally traumatizing measures. Vegetative shielding for hemodynamic stabilization.
Vegetative shielding for hemodynamic stabilization.