Zusammenfassung
Patienten auf Intensivstationen sind vital bedroht und einer Vielzahl von Prozeduren und Umgebungseinflüssen ausgesetzt, die Schmerz und Stress verursachen. Sowohl Schmerz, als auch Stress beeinflussen das Outcome von Intensivpatienten negativ. Aus diesem Grund ist es notwendig, ein analgosedierendes Therapieregime zur Hand zu haben, um diese negativen Einflüsse zu minimieren. Es gibt weder das ideale Analgetikum noch das ideale Sedativum. Die Mittel der Wahl zur Analgesie sind Opioide, wie Sufentanil, Remifentanil und Fentanyl. Zur Sedierung werden vorwiegend Propofol und Benzodiazepine, in Deutschland vorwiegend Midazolam, eingesetzt. Zur Bestimmung der Tiefe der Analgosedierung stehen uns verschieden Scoringsysteme zur Verfügung.
Abstract
Patients in intensive care units (ICU) are often in vital danger and subjected to a number of procedures and environmental conditions which are known to cause stress. Both pain and stress can negatively affect patient outcome. In order to minimize these factors, analgesia or sedation is required. However, there is neither an ideal analgesic nor an ideal sedative. The drugs of choice to minimize pain are opioids such as Fentanyl, Sufentanil, and Remifentanil. For sedation, we generally use Propofol or benzodiazepines – the latter is most commonly represented by Midazolam in Germany. There are several different systems available for scoring pain level, patient alertness or possible state of delirium.
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Eichler, I. Analgesie und Sedierung. Z Herz- Thorax- Gefäßchir 25, 33–37 (2011). https://doi.org/10.1007/s00398-010-0812-z
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DOI: https://doi.org/10.1007/s00398-010-0812-z