SCCM Resource Library-Recommendations Regarding Choices of Analgesics, Sedatives, and Neuromuscular Blocking Agents

Recommendations Regarding Choices of Analgesics, Sedatives, and Neuromuscular Blocking Agents

Video Transcription

Video Summary

John Birkenbach, a pediatric intensivist at Norton Children's Hospital, discusses key recommendations from the PEDS, PANDEM guidelines related to the choice of analgesic, sedative, and neuromuscular blocking agents in critically ill children. Pain and agitation are common in these patients, and it is important to provide appropriate analgesia and sedation. The guidelines recommend the use of IV opioids as the primary analgesic for moderate to severe pain, based on their widespread use and the lack of other viable options for longer-term analgesia. Non-opioid adjunct medications such as acetaminophen and nonsteroidal agents can be added to improve postoperative analgesia and decrease opioid exposure. For sedation, alpha-2 agonists are suggested as the primary class, as they have shown no difference in efficacy compared to benzodiazepines and may reduce the risk of delirium. Dexmedetomidine is recommended for postoperative cardiac surgical patients with planned early extubation. The guidelines also address the use of propofol, limiting its dose and duration to reduce the risk of propofol-related infusion syndrome. Neuromuscular blockers should be used with adequate analgesia and sedation to prevent awareness during their use. Further research is needed in this area.

Asset Subtitle

Pharmacology, 2022

Asset Caption

Identify key barriers to optimizing agent selection, facilitators for implementation/education/care, and create a protocol to standardize and monitor success.

Meta Tag

Content Type Presentation

Knowledge Area Pharmacology

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Analgesia and Sedation

Year 2022

Keywords

PEDS

PANDEM guidelines

analgesic choice

sedative choice

neuromuscular blocking agents

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