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
Postoperative pain management has become pre-requisite for early recovery after laparoscopic chole-cystectomy and the ideal management of it is definitely multimodal due to the complexity of its na-ture. Many analgesic approaches have already been tested to relieve pain after laparoscopic cholecys-tectomy and anticonvulsants drugs, like pregabalin and gabapentin might be useful and effec-tive.Pregabalin is an antiepileptic drug that is often used to treat neuropathic pain. The use of pre-gabalin as part of multimodal analgesia is still under evaluation and may have a role in the postopera-tive management, as an adjunct. Several studies have evaluated the efficacy and adverse effects of pregabalin in reducing postoperative pain and opioid consumption.In this review, we discuss the role of pregabalin in acute postoperative management after laparoscopic cholecystectomy. Based on avail-able clinical trials it is difficult to draw solid conclusions. More studies and especially well designed clinical trials are required in order to clarify the optimal dose and the duration of therapy before adopt-ing pregabalin in routine clinical practice.
Continue readingTreating children in an intensive care unit aims at the reversal of physiologic derangement of their organism while caring for comfortable physical and psychological environment. Any correctable environmental and physical factors causing discomfort should be addressed before the introduction of effective analgesia and sedation by pharmacological means; a normal schedule for sleep is desirable, and attention should be paid to the provision of feeding and hydration, lighting, environmental noise and the temporal orientation of the patients.
Continue readingIn the field of paediatric critical care, there is considerable uncertainty and variation in the area of analgesia and sedation in critically ill children. Consensus guidelines on sedation and analgesia in critically ill children are available since 2006, although clinical practice reveals variations both in pharmacological agents and regimens used.
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