Analgesia and sedation in the critically ill - a practical approach

Advancements in intensive care therapy have progressed rapidly over the las t two decades. Associated with this have been scientifically unsubstantiate d sedation and analgesia practices in the intensive care unit. There is lit tle consensus as to which agents are the most suitable, let alone when and how to use them. There are few, if any, placebo-controlled trials involving sedative drugs in critically ill patients. In an analysis of the literatur e, we have attempted to present a practical approach to sedation and analge sia practices in the critically ill patient. The aim is to present a framew ork upon which medical personnel managing critically ill patients can devel op a strategy for their own circumstances.