Medicina intensiva
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Pain is a problem in critically ill patients. The diagnosis of the intensity of is more simple when the patient is conscious (using ad hoc scales) than in unconscious or sedated patients. In these cases the study of the physiological responses to pain can be the best way of pain monitoring. ⋯ Morphine, fentanyl, remifentanyl and tramadole are the opioids more used critical ill patients. Ketamine, metamizole and acetaminophen must be considered as non-opioid alternative therapeutic. NSAIDS are non recommended for this group of patients.
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Numerous diagnostic techniques require sedation and analgesia in order to be performed in a safe and comfortable way for the patient. Several of the most notable points of interest for the critical care specialist are the electrical cardioversion, the placing of implantable cardiac stimulation devices, the endoscopic techniques and the performing of bedside surgical procedures. In this current revision, the SEMICYUC Task Force for Sedation and Analgesia describes recommendations and best practices for administering sedation and analgesia in these situations.