Abstract
Aim: to evaluate the process of sedation and analgesia in patients undergoing invasive mechanical ventilation (IMV). Method: cross-sectional, observational study conducted from September 2014 to February 2015 in the ICU of a teaching institution in Goiânia/GO. The sample consisted of 30 patients over 18 years old, intubated and sedated for more than 24 hours (protocol no. 763.827/2014). Results: continuous and intermittent sedation, and analgesia were used, with fentanyl and midazolam hydrochloride commonly used drugs. Discussion: the standard treatment for critically ill patients and submitted to IMV was continuous sedation administered due to anxiety in order to facilitate the nursing staff care. The main indication for sedation was the maintenance of IMV. Conclusion: lack standardization of approaches in the management of sedation. It is recommended to develop protocols with multidisciplinary effortReferences
Luna, AA, Sousa WA, Ferraz VM. Avaliação de delirium em pacientes em uso de sedativos. Rev Rede de Cuidados em Saúde. 2011; 5(1): 1- 11.
Nasraway SAJ, Jacobi J, Murray MJ, Lumb PD. Sedation, analgesia, and neuromuscular blockade of critically ill adult: Revised clinical practice guidelines for 2002. Critical Care Med. 2002; 30(1): 117-118.
Miranda ML, Bersot CD, Villela NR. Sedação, analgesia e bloqueio neuromuscular na unidade de terapia intensiva. Rev HUPE. 2013; 12(3): 102-109.
Barr J, Fraser LG, Puntillo K, Ely WE, Devlin JW, Kress JP, et al. Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Med. 2013; 41(1): 263-306.
Mendes CL, Vasconcelos LCS, Tavares JS, Fontan SB, Ferreira DC, Diniz LAC, et al. Escalas de Ramsay e Richmond são equivalentes para a avaliação do nível de sedação em pacientes gravemente enfermos. Rev Bras Terap Intensiva. 2008; 20(4): 344-348.
Jacobi J, Gilles LF, Douglas BC, Richard RR, Dorrie F, Eric TW et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Critical Care Med. 2002; 30(1): 119-141.
Kress JP, Hall JB. Sedation in the mechanically ventilated patient. Critical Care Med. 2006; 34(10): 2541-2546.
Barra DCC, Nascimento RP, Bernardes JFL. Analgesia e sedação em terapia intensiva: recomendações gerais. Rev Min Enferm. 2006; 10 (2): 176-180.
Schein LE, Cesar JA. Perfil de idosos admitidos em unidades de terapia intensiva gerais em Rio Grande, RS: resultados de um estudo de demanda. Rev Bras Epidemiol. 2010; 13(2): 289-301.
Juncal VR, Britto LAN, Camelier AA, Messeder OHC, Farias AMC. Impacto clínico do diagnóstico de sepse à admissão em UTI de um hospital privado em Salvador, Bahia. J Bras Pneumol. 2011; 37(1): 85-92.
Oliveira ABF, Dias OM, Mello MM, Araújo S, Dragosavac D, Nucci A, Falcão ALE. Fatores associados à maior mortalidade e tempo de internação prolongado em uma unidade de terapia intensiva de adultos. Rev Bras Ter Intensiva. 2010; 22(3): 250-256.
Strom T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet. 2010; 375 (9713): 475-80.
Salluh JI, Dal-Pizzol F, Mello PV, Friedman G, Silva E, Teles JM, Lobo SM et al. Brazilian Research in Intensive Care Network. Delirium recognition and sedation practices in critically ill patients: a survey on the attitudes of 1015 Brazilian critical care physicians. J Crit Care. 2009; 24(4): 556-62.
Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Leguillou JL et al. Current Practices in Sedation and Analgesia for Mechanically Ventilated Critically Ill Patients. Anesthesiology 2007; 106(4): 687-695.
Mehta S, McCullagh I, Burry L. Current sedation practices: lessons learned from international surveys. Anesthesiol Clin. 2011; 29(4): 607-624.
Shehabi Y, Chan L, Kadiman S, Alias A, Ismail WN, Tan MATI et al. Sedation depth and long-termmortality in mechanic ally ventilated critically ill adults: a prospective longitudinal multicentre cohort study. Intensive Care Med. 2013; 39:910-918.
Jackson DL, Proudfoot CW, Cann KF, Walsh TS. The incidence of sub-optimal sedation in the ICU: a systematic review. Critical Care. 2009; 13 (6): 1-14.
Costa JB, Marcon SS, Macedo CRL, Jorge AC, Duarte PAD. Sedação e memórias de pacientes submetidos à ventilação mecânica em unidade de terapia intensiva. Rev Bras Ter Intensiva. 2014; 26(2): 122-128.
Trikha A, Rewari, V. Sedation, Analgesia and Muscle Relaxation in the Intensive Care Unit. Indian Journal of Anaesthesia. 2008; 52 (5): 620-631.
Shinotsuka CR, Salluh JIF. Percepções e práticas sobre delirium, sedação e analgesia em pacientes críticos: uma revisão narrativa. Rev Bras Ter Intensiva. 2013; 25(2): 155-161.