Sedation and ParalysisDiscussion

Abstract

Sedation is used almost universally in the care of critically ill patients, especially in those who require mechanical ventilatory support or other life-saving invasive procedures. This review will focus on the sedation strategies for critically ill patients and the pharmacology of commonly used sedative agents. The role of neuromuscular blocking agents in the ICU will be examined and the pharmacology of commonly used agents is reviewed. Finally a strategy for rational use of these sedative and neuromuscular blocking agents in critically ill patients will be proposed.

Dystonic storm: a practical clinical and video review

“…Anesthetic agents typically used in dystonic storm include intravenous midazolam, propofol, and barbiturates. Intravenous midazolam is generally selected as a first choice due to its muscle relaxation effect, short half-life, rapid onset of action, and good cardiovascular profile [1, 9, 43]. If the symptoms are not controlled, propofol, an anesthetic with relatively short half-life, is generally considered as a second line agent.…”

Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) – short version

“…During neuromuscular blockade, patients cannot be awake, actively participate in their recovery, nor benefit from physiotherapy. When there is a specific indication for NMBAs, adequate analgesia and sedation should be provided [ 39 ]. Furthermore, the depth of blockade should be monitored [ 40 ], and the duration should be kept as short as possible (Table 17 (Tab.…”

Rocuronium-Induced Dilated Nonreactive Pupils in a Patient With Coronavirus Disease 2019: A Case Report

“…Clinical assessments included the observation of skeletal muscle movement, signs of ventilatory efforts, ventilator asynchrony, elevated peak airway pressures, and inspiratory triggering of the ventilator. 4 …”