Skip to main content

The Concept of Analgo-Sedation depends on the Concept of Mechanical Ventilation

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1995))

Abstract

New modes of ventilatory support enabling and encouraging patients’ spontaneous breathing influence the concepts of analgo-sedation in intensive care medicine. Formerly, when the restricting pattern of a totally controlled mechanical ventilation had to be used, a deep sedation and even neuromuscular blockade was often mandatory in order to adapt the patient to the ventilator and prevent him from ‘fighting’ [8]. A recent US national survey [7] indicated that sedative drugs and neuromuscular blocking agents are widely used for patients requiring mechanical ventilation in American ICUs. This means that sedation and myorelaxation become necessary for a therapy to be tolerated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bion JF, Ledingham I McA (1987) Sedation in intensive care — a postal study. Intensive Care Med 13: 215–216

    PubMed  CAS  Google Scholar 

  2. Byrne AJ, Yeoman PM, Mace P (1984) Accumulation of midazolam in patients receiving mechanical ventilation. Br Med J 289: 1309

    Article  Google Scholar 

  3. Freye E, Knüffermann V (1994) Keine Hemmung der intestinalen Motilität nach Ketamin-/ Midazolamnarkose. Ein Vergleich zur Narkose mit Enfluran und Fentanyl/Midazolam. Anaesthesist 43: 87–91

    Article  PubMed  CAS  Google Scholar 

  4. Gooch JL, Suchyta MR, Balbierz JM, Petajan JH, Clemmer TP (1991) Prolonged paralysis after treatment with neuromuscular junction blocking agents. Crit Care Med 19: 1125–1131

    Article  PubMed  CAS  Google Scholar 

  5. Grant IS, Nimmo WS, Clements JA (1981) Lack of effect of ketamine analgesia on gastric emptying in man. Br J Anaesth 53: 1321–1323

    Article  PubMed  CAS  Google Scholar 

  6. Griffin D, Fairman N, Coursin D, Rawthorne L, Grossman JE (1992) Acute myopathy during treatment of status asthmaticus with corticosteroids and steroidal muscle relaxants. Chest 102: 510–514

    Article  PubMed  CAS  Google Scholar 

  7. Hansen-Flaschen JH, Brazinsky S, Basile C, Lanken PN (1991) Use of sedating drugs and neuromuscular blocking agents in patients requiring mechanical ventilation for respiratory failure. A national survey. JAMA 266 (Suppl): 2870–2875

    Article  PubMed  CAS  Google Scholar 

  8. Marcy TW, Marini JJ (1991) Inverse ratio ventilation in ARDS. Rationale and implementation. Chest 100: 494–504

    Article  PubMed  CAS  Google Scholar 

  9. Op de Coul AAW, Verheul GAM, Leyten ACM, Schellens RLLA, Teepen JLJM (1991) Critical illness polyneuromyopathy after artificial respiration. Clin Neurol Neurosurg 93: 27–33

    Article  Google Scholar 

  10. Putensen C, Räsänen J, Lopez FA (1994) Ventilation-perfusion distributions during mechanical ventilation with superimposed spontaneous breathing in canine lung injury. Am J Respir Crit Care Med 150: 101–108

    PubMed  CAS  Google Scholar 

  11. Ramsay MAE, Savege TM, Simpson BRJ, Goodwin R (1974) Controlled sedation with alphaxalone-alphadalone. Br Med J 2: 656–659

    Article  PubMed  CAS  Google Scholar 

  12. Rathgeber J, Schorn B, Autschbach R, et al (1995) Biphasic intermittent positive airway pressure (BIPAP) ventilation reduces duration of intubation and consumption of analgesics and sedatives following adult cardiac surgery. A retrospective analysis in 596 patients. Intensive Care Med (in press)

    Google Scholar 

  13. Rossiter A, Souney PF, McGowan S, Carvajal P (1991) Pancuronium-induced prolonged neuromuscular blockade. Crit Care Med 19: 1583–1587

    Article  PubMed  CAS  Google Scholar 

  14. Slutsky AS (1994) Consensus conference on mechanical ventilation — January 28–30, 1993 at Northbrook, Illinois, USA. Part I. Intensive Care Med 20: 64–79

    Article  PubMed  CAS  Google Scholar 

  15. Slutsky AS (1994) Consensus conference on mechanical ventilation — January 28–30, 1993 at Northbrook, Illinois, USA. Part II. Intensive Care Med 20: 150–162

    Article  PubMed  CAS  Google Scholar 

  16. Sydow M, Burchardi H, Ephraim E, Zielmann S, Crozier TA (1994) Long-term effects of two different ventilatory modes on oxygenation in acute lung injury. — Comparison of airway pressures release ventilation and volume-controlled inverse ratio ventilation. Am J Respir Crit Care Med 149: 1550–1556

    PubMed  CAS  Google Scholar 

  17. Takahashi RN, Morato GS, Rae GA (1987) Effects of ketamine on nociception and gastrointestinal motility in mice are unaffected by naloxone. Gen Pharmacol 18: 201–203

    Article  PubMed  CAS  Google Scholar 

  18. Wheeler AP (1993) Sedation, analgesia, and paralysis in the intensive care unit. Chest 104: 566–577

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Burchardi, H., Rathgeber, J., Sydow, M. (1995). The Concept of Analgo-Sedation depends on the Concept of Mechanical Ventilation. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1995. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79154-3_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79154-3_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58256-4

  • Online ISBN: 978-3-642-79154-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics