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Yoğun bakımda sedasyon ve analjezi ihtiyacı

Yıl 2013, Cilt: 30 Sayı: 1s, 25 - 31, 28.11.2013

Öz

Yoğun bakım hastalarında invaziv girişimler, entübasyon, trakeal aspirasyon, pansuman ve pozisyon değişimi gibi işlemler sırasında sedatif ve analjezik gereksinimi olabilir. Çok geniş yelpazede olan bu ilaçlar, yoğun bakım kalış sürelerinde uzama, immünsüpresyon gibi olumsuzluklara neden olabilir, bu yüzden ilaç ve doz seçimi konusunda hassas davranılmalıdır.

Sedation and analgesia requirement in intensive care unit

Intensive care patients may require sedation and analgesia during procedures like intubation, tracheal aspiration, dressing, position change and invasive approaches. These drugs have a wide range and they may cause prolongation of stay in intensive care unit and immunosupresion; so we must be careful in choosing the drug and dose.

Kaynakça

  • Achar, S., Kundu, S., 2002. Principles of office anesthesia: Part I. Infiltrative anesthesia. Am. Fam. Physician. 1, 91-94.
  • Aitkenhead, A.R., Pepperman, M.L., Willatts, S.M., Coates, P.D., Park, G.R., Bodenham, A.R., Collins, C.H., Smith, M.B., Ledingham, I.M., Wallace, P.G., 1989. Comparison of propofol and midazolam for sedation in critically ill patients. Lancet. 23, 704-709.
  • Atanassoff, P.G., Alon, E., Pasch, T., Ziegler, W.H., Gautschi, K., 1991. Intercostal nerve block for minor breast surgery. Reg Anesth. 16, 23-27. Batra, R.K., Krishnan, K., Agarwal, A., 2011. Paravertebral block. J. Anaesthesiol. Clin. Pharmacol. 27, 5-11.
  • Bauer, M., George, J.E. 3rd., Seif, J., Farag, E., 2012. Recent advances in epidural analgesia. Anesthesiol. Res. Pract. 309219.
  • Bechtoldt, A.A., Murray, W.J., 1968. Innovar-induced respiratory depression. Anesth Analg. 47, 395-398.
  • Blunk, J.A., Schmelz, M., Zeck, S., Skov, P., Likar, R., Koppert, W., 2004. Opioid-induced mast cell activation and vascular responses is not mediated by mu-opioid receptors: An in vivo microdialysis study in human skin. Anesth. Analg. 98, 364-370.
  • Caraceni, A., Zecca, E., Martini, C., Gorni, G., Campa, T., Brunelli, C., De Conno, F., 2012. Palliative sedation at the end of life at a tertiary cancer center. Support Care Cancer. 20, 1299-1307.
  • Carstensen, M., Moller, A.M., 2010. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: A qualitative review of randomized trials. Brit. J. Anaesth. 104, 401-406.
  • Chlan, L.L., Weinert, C.R., Skaar, D.J., Tracy, M.F., 2010. Patient-controlled sedation: A novel approach to sedation management for mechanically ventilated patients. Chest. 138, 11045-11053.
  • Consales, G., Chelazzi, C., Rinaldi, S., De Gaudio, A.R., 2006. Bispectral index compared to Ramsay score for sedation monitoring in intensive care units. Minerva Anestesiol. 72, 329-336.
  • Cousins, M.J., Mather, L.E., 1984. Intrathecal and epidural administration of opioids. Anesthesiology. 61, 276.
  • Delwaux, B., Ryckwaert, Y., Van, Boven, M., De Kock, M., Capdevila, X., 2005. Remifentanil in the intensive care unit: Tolerance and acute withdrawal syndrome after prolonged sedation. Anaesthesiology. 102, 1281-1282.
  • Ellett, M.L., 2010. Review of propofol and auxiliary medications used for sedation. Gastroenterol Nurs. 33, 284-295.
  • Fassoulaki, A., Theodoraki, K., Melemeni, A., 2010. Pharmacology of sedation agents and reversal agents. Digestion. 82, 808-803.
  • Gertler, R., Brown, H.C., Mitchell, D.H., Silvius, E.N., 2001. Dexmedetomidine: A novel sedative-analgesic agent. Proc. (Bayl Univ Med Cent). 14, 13-21.
  • Giese, J.L., Stanley, T.H., 1983. Etomidate: A new intravenous anesthetic induction agent. Pharmacotherapy. 3, 251-258.
  • Gupta, K., Gupta, V.K., Jayashree, M., Singhi, S., 2012. Randomized controlled trial of interrupted versus continuous sedative infusions in ventilated children. Pediatr. Crit. Care Med. 13, 131-135.
  • Haas, D.A., Harper, D.G., 1992. Ketamine: A review of its pharmacologic properties and use in ambulatory anesthesia. Anesth. Prog. 39, 61-68. Hall, J.E., Uhrich, T.D., Ebert, T.J., 2001. Sedative, analgesic and cognitive effects of clonidine infusions in humans. Br. J. Anaesth. 86, 5-11.
  • Hayek, S.M., Deer, T.R., Pope, J.E., Panchal, S.J., Patel, V.B., 2011. Intrathecal therapy for cancer and non-cancer pain. Pain Physician. 14, 219-2
  • Herman, R.J., Wilkinson, G.R., 1996. Disposition of diazepam in young and elderly subjects after acute and chronic dosing. Br. J. Clin. Pharmacol. 42, 147-155.
  • Hildreth, A.N., Mejia, V.A., Maxwell, R.A., Smith, P.W, Dart, B.W., Barker, D.E., 2008. Adrenal suppression following a single dose of etomidate for rapid sequence induction: A prospective randomized study. J. Trauma. 65, 573-579.
  • Kara, B., Baskurt, F., Acar, S., Karadibak, D., Ciftci, L., Erbayraktar, S., Gokmen, A.N., 2011. The effect of TENS on pain, function, depression, and analgesic consumption in the early postoperative period with spinal surgery patients. Turk. Neurosurg. 21, 618-624.
  • Kay, B., 1976. A dose-response relationship for etomidate with some observations on cumulation. Br J Anaesth. 48, 213-216.
  • Kröll, W., List, W.F., 1997. Pain treatment in the ICU: Intravenous, regional or both? Eur. J. Anaesthesiol Suppl. 15, 49-52.
  • Lötsch, J., 2005. Pharmacokinetic-pharmacodynamic modeling of opioids. J. Pain. Symptom Manage. 29, 90-103.
  • Malchow, R.J., Black, I.H., 2008. The evolution of pain management in the critically ill trauma patient: Emerging concepts from the global war on terrorism. Crit Care Med. 36, 346-357. doi: 10.1097/CCM.0b013e31817e2fc9.
  • Mandabach, M.G., 1999. Intrathecal and epidural analgesia. Crit. Care Clin. 15, 105-118.
  • Min, J.H., Chai, H.S., Kim, Y.H., Chae, Y.K., Choi, S.S., Lee, A., Choi, Y.S., 2010. Attenuation of hemodynamic responses to laryngoscopy and tracheal intubation during rapid sequence induction: Remifentanil vs. lidocaine with esmolol. Minerva Anestesiol. 76, 188-192.
  • Murray, M.J., 1990. Pain problems in the ICU. Crit. Care Clin. 6, 729-736.
  • Murray, M.J., Plevak, D.J., 1994. Analgesia in Critically ill patient. New Horiz. 2, 56-63.
  • Namukwaya, E., Leng, M., Downing, J., Katabira, E., 2011. Cancer pain management in resource-limited settings: A practice review. Pain Res. Treat. 2011, 393-404.
  • Olkkola, K.T., Ahonen, J., 2008. Midazolam and other benzodiazepines. Handb. Exp. Pharmacol. 182, 335-360.
  • Panzer, O., Moitra, V., Sladen, R.N., 2011. Pharmacology of sedative-analgesic agents: Dexmedetomidine, remifentanil, ketamine, volatile anesthetics, and the role of peripheral Mu antagonists. Anesthesiol. Clin. 29, 587-605.
  • Portenoy, R.K., 1987. Continuous intravenous infusion of opioid drugs. Med. Clin. North. Am. 71, 233-241.
  • Raeder, J.C., Stenseth, L.B., 2000. Ketamine: A new look at an old drug. Curr Opin. Anaesthesiol. 13, 463-468.
  • Ramajoli, F., De Amici, D., 1998. Is there a bilateral block of the thoracic sympathetic chain after unilateral intrapleural analgesia? Anesth. Analg. 87, 360-367.
  • Rao, T.L.X., Mummanene, N., EI-Etr, A.A., 1982. Convulsions: An unusual response to intravenous fentanyl administration. Anesth. Analg. 61, 1020-1021.
  • Reschreiter, H., Maiden, M., Kapila, A., 2008. Sedation practice in the intensive care unit: A UK national survey. Crit Care. 12, 152. doi: 10.1186/ Yoğun bakım hastalarının sedasyon ve analjezi ihtiyacı kişisel özellikler, hastanın patolojisi, anksiyetesi, ağrı deneyimi, yapılacak işlem, ekipman, maliyet göz önüne alınarak belirlenmeli ve uygulama deneyimli kişiler tarafından yapılmalıdır (Chlan ve ark., 2010).
Yıl 2013, Cilt: 30 Sayı: 1s, 25 - 31, 28.11.2013

Öz

Kaynakça

  • Achar, S., Kundu, S., 2002. Principles of office anesthesia: Part I. Infiltrative anesthesia. Am. Fam. Physician. 1, 91-94.
  • Aitkenhead, A.R., Pepperman, M.L., Willatts, S.M., Coates, P.D., Park, G.R., Bodenham, A.R., Collins, C.H., Smith, M.B., Ledingham, I.M., Wallace, P.G., 1989. Comparison of propofol and midazolam for sedation in critically ill patients. Lancet. 23, 704-709.
  • Atanassoff, P.G., Alon, E., Pasch, T., Ziegler, W.H., Gautschi, K., 1991. Intercostal nerve block for minor breast surgery. Reg Anesth. 16, 23-27. Batra, R.K., Krishnan, K., Agarwal, A., 2011. Paravertebral block. J. Anaesthesiol. Clin. Pharmacol. 27, 5-11.
  • Bauer, M., George, J.E. 3rd., Seif, J., Farag, E., 2012. Recent advances in epidural analgesia. Anesthesiol. Res. Pract. 309219.
  • Bechtoldt, A.A., Murray, W.J., 1968. Innovar-induced respiratory depression. Anesth Analg. 47, 395-398.
  • Blunk, J.A., Schmelz, M., Zeck, S., Skov, P., Likar, R., Koppert, W., 2004. Opioid-induced mast cell activation and vascular responses is not mediated by mu-opioid receptors: An in vivo microdialysis study in human skin. Anesth. Analg. 98, 364-370.
  • Caraceni, A., Zecca, E., Martini, C., Gorni, G., Campa, T., Brunelli, C., De Conno, F., 2012. Palliative sedation at the end of life at a tertiary cancer center. Support Care Cancer. 20, 1299-1307.
  • Carstensen, M., Moller, A.M., 2010. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: A qualitative review of randomized trials. Brit. J. Anaesth. 104, 401-406.
  • Chlan, L.L., Weinert, C.R., Skaar, D.J., Tracy, M.F., 2010. Patient-controlled sedation: A novel approach to sedation management for mechanically ventilated patients. Chest. 138, 11045-11053.
  • Consales, G., Chelazzi, C., Rinaldi, S., De Gaudio, A.R., 2006. Bispectral index compared to Ramsay score for sedation monitoring in intensive care units. Minerva Anestesiol. 72, 329-336.
  • Cousins, M.J., Mather, L.E., 1984. Intrathecal and epidural administration of opioids. Anesthesiology. 61, 276.
  • Delwaux, B., Ryckwaert, Y., Van, Boven, M., De Kock, M., Capdevila, X., 2005. Remifentanil in the intensive care unit: Tolerance and acute withdrawal syndrome after prolonged sedation. Anaesthesiology. 102, 1281-1282.
  • Ellett, M.L., 2010. Review of propofol and auxiliary medications used for sedation. Gastroenterol Nurs. 33, 284-295.
  • Fassoulaki, A., Theodoraki, K., Melemeni, A., 2010. Pharmacology of sedation agents and reversal agents. Digestion. 82, 808-803.
  • Gertler, R., Brown, H.C., Mitchell, D.H., Silvius, E.N., 2001. Dexmedetomidine: A novel sedative-analgesic agent. Proc. (Bayl Univ Med Cent). 14, 13-21.
  • Giese, J.L., Stanley, T.H., 1983. Etomidate: A new intravenous anesthetic induction agent. Pharmacotherapy. 3, 251-258.
  • Gupta, K., Gupta, V.K., Jayashree, M., Singhi, S., 2012. Randomized controlled trial of interrupted versus continuous sedative infusions in ventilated children. Pediatr. Crit. Care Med. 13, 131-135.
  • Haas, D.A., Harper, D.G., 1992. Ketamine: A review of its pharmacologic properties and use in ambulatory anesthesia. Anesth. Prog. 39, 61-68. Hall, J.E., Uhrich, T.D., Ebert, T.J., 2001. Sedative, analgesic and cognitive effects of clonidine infusions in humans. Br. J. Anaesth. 86, 5-11.
  • Hayek, S.M., Deer, T.R., Pope, J.E., Panchal, S.J., Patel, V.B., 2011. Intrathecal therapy for cancer and non-cancer pain. Pain Physician. 14, 219-2
  • Herman, R.J., Wilkinson, G.R., 1996. Disposition of diazepam in young and elderly subjects after acute and chronic dosing. Br. J. Clin. Pharmacol. 42, 147-155.
  • Hildreth, A.N., Mejia, V.A., Maxwell, R.A., Smith, P.W, Dart, B.W., Barker, D.E., 2008. Adrenal suppression following a single dose of etomidate for rapid sequence induction: A prospective randomized study. J. Trauma. 65, 573-579.
  • Kara, B., Baskurt, F., Acar, S., Karadibak, D., Ciftci, L., Erbayraktar, S., Gokmen, A.N., 2011. The effect of TENS on pain, function, depression, and analgesic consumption in the early postoperative period with spinal surgery patients. Turk. Neurosurg. 21, 618-624.
  • Kay, B., 1976. A dose-response relationship for etomidate with some observations on cumulation. Br J Anaesth. 48, 213-216.
  • Kröll, W., List, W.F., 1997. Pain treatment in the ICU: Intravenous, regional or both? Eur. J. Anaesthesiol Suppl. 15, 49-52.
  • Lötsch, J., 2005. Pharmacokinetic-pharmacodynamic modeling of opioids. J. Pain. Symptom Manage. 29, 90-103.
  • Malchow, R.J., Black, I.H., 2008. The evolution of pain management in the critically ill trauma patient: Emerging concepts from the global war on terrorism. Crit Care Med. 36, 346-357. doi: 10.1097/CCM.0b013e31817e2fc9.
  • Mandabach, M.G., 1999. Intrathecal and epidural analgesia. Crit. Care Clin. 15, 105-118.
  • Min, J.H., Chai, H.S., Kim, Y.H., Chae, Y.K., Choi, S.S., Lee, A., Choi, Y.S., 2010. Attenuation of hemodynamic responses to laryngoscopy and tracheal intubation during rapid sequence induction: Remifentanil vs. lidocaine with esmolol. Minerva Anestesiol. 76, 188-192.
  • Murray, M.J., 1990. Pain problems in the ICU. Crit. Care Clin. 6, 729-736.
  • Murray, M.J., Plevak, D.J., 1994. Analgesia in Critically ill patient. New Horiz. 2, 56-63.
  • Namukwaya, E., Leng, M., Downing, J., Katabira, E., 2011. Cancer pain management in resource-limited settings: A practice review. Pain Res. Treat. 2011, 393-404.
  • Olkkola, K.T., Ahonen, J., 2008. Midazolam and other benzodiazepines. Handb. Exp. Pharmacol. 182, 335-360.
  • Panzer, O., Moitra, V., Sladen, R.N., 2011. Pharmacology of sedative-analgesic agents: Dexmedetomidine, remifentanil, ketamine, volatile anesthetics, and the role of peripheral Mu antagonists. Anesthesiol. Clin. 29, 587-605.
  • Portenoy, R.K., 1987. Continuous intravenous infusion of opioid drugs. Med. Clin. North. Am. 71, 233-241.
  • Raeder, J.C., Stenseth, L.B., 2000. Ketamine: A new look at an old drug. Curr Opin. Anaesthesiol. 13, 463-468.
  • Ramajoli, F., De Amici, D., 1998. Is there a bilateral block of the thoracic sympathetic chain after unilateral intrapleural analgesia? Anesth. Analg. 87, 360-367.
  • Rao, T.L.X., Mummanene, N., EI-Etr, A.A., 1982. Convulsions: An unusual response to intravenous fentanyl administration. Anesth. Analg. 61, 1020-1021.
  • Reschreiter, H., Maiden, M., Kapila, A., 2008. Sedation practice in the intensive care unit: A UK national survey. Crit Care. 12, 152. doi: 10.1186/ Yoğun bakım hastalarının sedasyon ve analjezi ihtiyacı kişisel özellikler, hastanın patolojisi, anksiyetesi, ağrı deneyimi, yapılacak işlem, ekipman, maliyet göz önüne alınarak belirlenmeli ve uygulama deneyimli kişiler tarafından yapılmalıdır (Chlan ve ark., 2010).
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil tu
Bölüm Surgery Medical Sciences
Yazarlar

Binnur Sarıhasan Bu kişi benim

Yasemin Üstün

Yayımlanma Tarihi 28 Kasım 2013
Gönderilme Tarihi 2 Mart 2012
Yayımlandığı Sayı Yıl 2013 Cilt: 30 Sayı: 1s

Kaynak Göster

APA Sarıhasan, B., & Üstün, Y. (2013). Yoğun bakımda sedasyon ve analjezi ihtiyacı. Journal of Experimental and Clinical Medicine, 30(1s), 25-31. https://doi.org/10.5835/jecm.omu.30.s1.004
AMA Sarıhasan B, Üstün Y. Yoğun bakımda sedasyon ve analjezi ihtiyacı. J. Exp. Clin. Med. Kasım 2013;30(1s):25-31. doi:10.5835/jecm.omu.30.s1.004
Chicago Sarıhasan, Binnur, ve Yasemin Üstün. “Yoğun bakımda Sedasyon Ve Analjezi Ihtiyacı”. Journal of Experimental and Clinical Medicine 30, sy. 1s (Kasım 2013): 25-31. https://doi.org/10.5835/jecm.omu.30.s1.004.
EndNote Sarıhasan B, Üstün Y (01 Kasım 2013) Yoğun bakımda sedasyon ve analjezi ihtiyacı. Journal of Experimental and Clinical Medicine 30 1s 25–31.
IEEE B. Sarıhasan ve Y. Üstün, “Yoğun bakımda sedasyon ve analjezi ihtiyacı”, J. Exp. Clin. Med., c. 30, sy. 1s, ss. 25–31, 2013, doi: 10.5835/jecm.omu.30.s1.004.
ISNAD Sarıhasan, Binnur - Üstün, Yasemin. “Yoğun bakımda Sedasyon Ve Analjezi Ihtiyacı”. Journal of Experimental and Clinical Medicine 30/1s (Kasım 2013), 25-31. https://doi.org/10.5835/jecm.omu.30.s1.004.
JAMA Sarıhasan B, Üstün Y. Yoğun bakımda sedasyon ve analjezi ihtiyacı. J. Exp. Clin. Med. 2013;30:25–31.
MLA Sarıhasan, Binnur ve Yasemin Üstün. “Yoğun bakımda Sedasyon Ve Analjezi Ihtiyacı”. Journal of Experimental and Clinical Medicine, c. 30, sy. 1s, 2013, ss. 25-31, doi:10.5835/jecm.omu.30.s1.004.
Vancouver Sarıhasan B, Üstün Y. Yoğun bakımda sedasyon ve analjezi ihtiyacı. J. Exp. Clin. Med. 2013;30(1s):25-31.