Critical care sedation for neuroscience patients

Journal of the Neurological Sciences
M A Mirski, Mitzi K Hemstreet

Abstract

In 2000, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced the mandate for the implementation of standards for both pain assessment and need for therapy in hospitalized patients. The need for the appropriate titration of sedation and analgesia is particularly poignant in an intensive care unit (ICU) setting where iatrogenic discomfort often complicates patient management. Neurologically ill patients in ICUs present particularly complex sedation issues, owing to the need to monitor these patients with serial neurological exams. Hence, maximal comfort without diminishing neurological responsiveness is desirable. Here, we review the frequently applied methods of evaluating levels of pain and agitation in critically ill patients as well as discuss the appropriate classes of pharmaceutical agents common to this population, with particular emphasis on the potential neurophysiological impact of such therapy.

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Related Concepts

Care of Intensive Care Unit Patient
Subacute Delirium
Dose-Response Relationship, Drug
Drug Interactions
Sedatives
Monitoring, Physiologic
Nervous System Disorder
Anti-Anxiety Effect

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