Sedacija i analgezija u intenzivnoj medicini

master's thesis

• Title (english): Sedation and analgesia in Intensive care medicine
• Author: Lucija Matošin
• Mentor: DINKO TONKOVIĆ (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: Daniela Bandić Pavlović (član povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Sedacija i analgezija su iznimno bitne u jedinici intenzivnog liječenja. Učinkovita analgezija i sedacija ne uključuje samo fizičko, već i psihološko stanje pacijenta. U sedaciji pacijenta, osim već tradicionalnih sedirajućih sredstava, zadnjih nekoliko godina u Europi novost je kratko sedirajući deksamedetomidin koji ima mnoge prednosti nad starijim sedirajućim sredstvima poput kooperativne sedacije, oponašanja sna, smanjenje respiratorne depresije i sindroma ustezanja. Pristup boli u jedinici intenzivnog liječenja može biti zahtjevan i izazovan, upravo zbog činjenice da mnogi pacijenti bilo zbog sedacije, smanjenja svjesnosti ili nekog drugog razloga ne mogu verbalno i potpuno pružiti informaciju o postojanju i vrsti boli. Bol je subjektivno iskustvo i kod pacijenta koji se žali na bol uvijek je najbitniji indikator za djelovanje i primjenu analgetika. Kod ventiliranih, sediranih ili pacijenata sa smanjenom razinom svijesti, nemogućnost komunikacije ne smije spriječiti propisivanje i davanje analgetika iako se možda čini da pacijent nije u bolnom stanju. Zbog toga su razvijene skale za procjenu boli poput vizualne analogne skale, bihevioralne skale, numeričke skala i mnoge druge. Ponašanje vezano uz bol i psihološki indikatori nisu specifični isključivo za bol, no njihova prisutnost treba biti rutinski dokumentirana, pogotovo u onih koji su u nemogućnosti komuniciranja.

Abstract (english)

Sedation and analgesia are recognized as important areas of critical care practice. Effective analgesia and sedation involve caring for both the physical and psychological comfort of critically ill patients. In sedation, except older traditional sedatives, last few years in Europe, there is a new short-term sedative called Dexmedetomidine which has many advantages like cooperative sedation, mimicry of sleep, decreasing of respiratory depression and withdrawal syndrome. The assessment of acute pain in the ICU can be challenging. Unfortunately, many ICU patients cannot provide full or even partial information regarding their pain. Pain is a subjective experience, and in the absence of a clear reason to doubt them, a patient’s reporting of his or her pain is the single most reliable indicator of pain and must be considered the standard to guide analgesic therapy. However, the inability of ventilated, sedated ICU patients to report pain should not
preclude its assessment and management. A number of scales and assessment tools for the evaluation of pain in ICU patients have been developed, such as the visual analog scale, the numeric rating scale, behavioral pain scale, and critical care pain observation scale. Whilst pain-related behaviors and physiological indicators of pain are neither sensitive nor specific to pain, their presence should be routinely documented, especially in those unable to communicate normally.

• Keywords: sedacija; analgezija; jedinica intenzivnog liječenja; deksmedetomidin; skale za procjenu
• Keywords (english): sedation; analgesia; intensive care unit; dexmedetomidine; assessment scales
• Language: croatian
• URN:NBN: urn:nbn:hr:105:055044
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-19 12:58:50