Procedural sedation and analgesia (PSA) is often necessary in order to deal with anxiety, pain and stress that may accompany patients at the hospital during invasive, unpleasant and/or painful procedures. The literature has not presented firm conclusions regarding ideal sedative agents in terms of efficacy and safety in PSA or even present firm data regarding superiority of specific drugs over others which are considered the “gold-standard” in sedation (i.e. propofol). Continue reading
Patients admitted to Intensive Care Units (ICU) have the highest mortality rates among hospitalized patients. For those who survive, recovery is often a prolonged rehabilitation period with physical, cognitive and psychological dysfunction. The aim of the present narrative review was to identify in the existing literature articles providing information about the development of chronic pain after ICU stay. We performed a PubMed search for publications up to 22 March 2020. We identified 41 articles eligible to be included in the present review; 29 of them were original research articles. Pre-existing chronic pain, previous poor health- related quality of life (HRQoL), but also the critical illness itself and organ support with multiple interventions, predispose to the development of chronic pain in the post-critical period, making it difficult to return to the pre-disease functional status. Opioid administration during mechanical ventilation is a common practice, frequently without reliable and systematic assessment of pain or individualized titration of dosage. Continue reading
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