Sedation and analgesia in pediatric critical care units

Abstract

Critically ill pediatric patients are exposed to potentially painful and stressful procedures during their stay in intensive care units. They often require specific drugs to take care of pain and discomfort.

Under sedated patients can experiment immediate physiologic deleterious changes. They are also at risk of long-term neuro developmental impairments.

Conversely, over sedation can lead to short-term adverse effects but also to prolonged length of mechanical ventilation and ICU stay. 

Reaching optimal sedation and analgesia is challenging but feasible for pediatric patients. Validated and appropriate tools such as pain and sedation scales for the pediatric population exist. Experts recommend using them at the beginning of a treatment and all along the IUC stay to optimize pain and sedation support.

In order to improve sedation and analgesia management in the pediatric population, many strategies have been developed such as lowering the doses of the different molecules, multimodal approach, and the use of nurse driven protocols. Since these patients are at high risk of developing withdrawal and delirium, clinicians should actively seek for and treat these complications.