Evaluating and monitoring analgesia and sedation in the intensive care unit.docVIP

Available online /content/12/S3/S2 Review Evaluating and monitoring analgesia and sedation in the intensive care unit Curtis N Sessler1,2, Mary Jo Grap3 and Michael AE Ramsay4 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Virginia Commonwealth University Health System, Richmond, Virginia 23298, USA 2Medical Director of Critical Care, Medical College of Virginia Hospitals, Richmond, Virginia 23298, USA 3Department of Adult Health Nursing, School of Nursing, VCU, East Leigh St., Richmond, Virginia 23298, USA 4Department of Anesthesiology, Baylor University Medical Center, Gaston Avenue, Dallas, Texas 75246, USA Corresponding author: Curtis N Sessler, csessler@ Published: 14 May 2008 Critical Care 2008, 12(Suppl 3):S2 (doi:10.1186/cc6148) This article is online at /content/12/S3/S2 ? 2008 BioMed Central Ltd Abstract the needs of the patient, subjective and/or objective measure- ment of the key variables (such as pain, agitation, and level of consciousness), and titration of therapy to achieve specific targets [1-4]. It is important to recognize that patient needs can differ depending upon clinical circumstances, and that for any given patient therapeutic targets are likely to change over time. Thus, achieving patient comfort and ensuring patient Management of analgesia and sedation in the intensive care unit requires evaluation and monitoring of key parameters in order to detect and quantify pain and agitation, and to quantify sedation. The routine use of subjective scales for pain, agitation, and sedation promotes more effective management, including patient- focused titration of medications to specific end-points. The need for frequent measurement reflects the dynamic nature of pain, agitation, and sedation, which change constantly in critically ill patients. Further, close monitoring promotes repeated evaluation of response to therapy, thus helping to