Principles of Critical Care > Part II. General Management of the Patient > Chapter 14. Pain Control, Sedation, and Use of Muscle Relaxants Brian Gehlbach,  John P. Kress

Key Points

"Administration of analgesics and sedatives is commonplace in the ICU. Unfortunately, many early studies of analgesic and sedative medications were performed in the operating room, a setting very different from the ICU. The clinician must recognize the diverse and often unpredictable effects of critical illness on the pharmacokinetics and pharmacodynamics of sedatives and analgesics. Failure to recognize these effects may lead to inadequate or excessive sedation. Sedatives and analgesics may cause prolonged alterations in mental status and may mask the development of coincident complications of critical illness. Data studying the effects of analgesia and sedation in the ICU have accumulated in the last decade and have had important influences on this aspect of critical care. As outcomes data have become available, analgesia and sedation practices driven by protocol guidelines have emerged...."