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9.11 - Analgesia and Sedation in the Paediatric Intensive Care Unit

from Section 9 - Paediatric Care

Published online by Cambridge University Press:  27 July 2023

By
Andrew J. Jones  and
Thomas Brick
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. There is significant variation in practice in choice of analgesic and sedative agents amongst paediatric intensive care units (PICUs).

  2. 2. There are validated pain and sedation scales for assessment of children.

  3. 3. Morphine is often used alone for both sedation and analgesia in neonates.

  4. 4. Propofol infusions are rarely used for sedation on PICU.

  5. 5. An intravenous bolus of ketamine at 1–2 mg/kg is the induction agent of choice for the critically ill, hypotensive child.

Keywords

analgesiasedationPICUCOMFORT scale
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 726 - 730
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Ambuel, B, Hamlett, KW, Marx, CM, et al. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol 1992;17:95–109.Google Scholar
Bellieni, CV, Cordelli, DM, Raffaelli, M, Ricci, B, Morgese, G, Buonocore, G. Analgesic effect of watching TV during venipuncture. Arch Dis Child 2006;91:1015–17.Google Scholar
Hunseler, C, Balling, G, Rohlig, C, et al. Continuous infusion of clonidine in ventilated newborns and infants. Pediatr Crit Care Med 2014;15:511–22.Google Scholar
Jenkins, IA, Playfor, SD, Bevan, C, Davies, G, Wolf, AR. Current United Kingdom sedation practice in pediatric intensive care. Pediatr Anesth 2007;17:675–83.Google Scholar
Playfor, SD. Analgesia and sedation in critically ill children. Contin Educ Anaesth Crit Care Pain 2008;8:90–4.Google Scholar
Saleh, RH. Randomized controlled comparative trial between low dose dexmedetomidine sedation and that of fentanyl in children after surgical procedures in surgical pediatric intensive care unit. Egyptian J Anaesth 2016;32:137–42.Google Scholar
Striker, TW, Stool, S, Downes, JJ. Prolonged nasotracheal intubation in infants and children. Arch Otolaryngol 1967;85:210–13.Google Scholar
Tarbel, SE, Cohen, IT, March, JL. The Toddler-Preschooler Postoperative Pain Scale: an observational scale for measuring post-operative pain in children aged 1–5 years. A preliminary report. Pain 1992;50:273–80.Google Scholar
Wolf, A, McKay, A, Spowart, C, et al. Prospective multicentre randomised, double-blind, equivalence study comparing clonidine and midazolam as intravenous sedative agents in critically ill children: the SLEEPS (Safety profiLe, Efficacy and Equivalence in Paediatric intensive care Sedation) study. Health Technol Assess 2014;18:1–212.CrossRefGoogle ScholarPubMed

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