Sedation and Analgesia in the Pediatric Intensive Care Unit Following Laryngotracheal Reconstruction

2008 ◽  
Vol 41 (5) ◽  
pp. 1023-1044 ◽  
Author(s):  
Gregory B. Hammer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Laryngotracheal Reconstruction ◽  
Sedation And Analgesia

Out-patient Therapy of Iatrogenic Opioid Dependency following Prolonged Sedation in the Pediatric Intensive Care Unit

1996 ◽  
Vol 11 (5) ◽  
pp. 284-287 ◽  
Author(s):  
Joseph D. Tobias
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Opioid Withdrawal ◽  
Opioid Dependency ◽  
Oral Methadone ◽  
Prolonged Sedation ◽  
Sedation And Analgesia ◽  
Patient Use

As a result of heightened awareness of the need for aggressive sedation and analgesia in the pediatric intensive care unit population, the risk for opioid withdrawal continues to increase. Although gradual tapering of the intravenous dose of opioid can be used to prevent such problems, this approach mandates maintenance of intravenous access and in-patient hospital admission. I present experience with the out-patient use of oral methadone to prevent opioid withdrawal following prolonged fentanyl sedation in the pediatric intensive care unit. A cohort of 18 patients is reviewed, and suggested guidelines for out-patient management of these patients using oral methadone are presented.

Sedation and Analgesia for Children in the Pediatric Intensive Care Unit

1995 ◽  
Vol 10 (6) ◽  
pp. 294-314 ◽  
Author(s):  
Joseph D. Tobias
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Anesthetic Techniques ◽  
Anesthetic Agents ◽  
Inhalational Anesthetic ◽  
Sedation And Analgesia ◽  
Alternative Routes ◽  
Control Pain

Several situations arise in the Pediatric Intensive Care Unit (PICU) patient which may require the pharmacologic control of pain and anxiety. The author discusses the various pharmacologic agents available for sedation and analgesia including the inhalational anesthetic agents, nitrous oxide, benzodiasepines, opioids, ketamine, propofol, and the barbiturates. While intravenous administration is generally chosen for the PICU patient, certain situations may arise which preclude this route. The available information concerning alternative routes of delivery for the various agents including subcutaneous and transmucosal administration is presented. The role of various regional anesthetic techniques to control pain in the PICU patient are reviewed.

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