Swiss medical weekly
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In critically ill patients, adequate analgesia and sedation increase comfort, reduce stress response and facilitate diagnostic and therapeutic procedures. Analgesia and sedation may also have a beneficial impact on morbidity, particularly by reducing pulmonary complications such as atelectasis and pneumonia, and delirium or agitation with subsequent accidental extubation. The method and depth of analgesia and sedation should be adapted to the needs of the individual patient. ⋯ In Europe, midazolam and propofol are most frequently used for sedation of the critically ill. Regular evaluation of the effect of these drugs and subsequent adaptation of dosage are more important than the choice of specific analgesics and hypnotics. Implementation of guidelines for rational analgesia and sedation would help to reduce patients' length of stay in the intensive care unit.