Sedation and Analgesia for Pediatric Trauma Patient

Sevgi TOPALa , Agop ÇITAKa

aAcıbadem University Acıbadem Altunizade Hospital, Department of Pediatric Intensive Care, İstanbul, Türkiye

ABSTRACT
Pain is the feeling of discomfort that occurs as a result of tissue damage. Anxiety is a multi-system response to a perceived threat. Controlling pain and anxiety by administering sedation and analgesia is part of standard medical practice in the pediatric intensive care unit (PICU). The aim is to minimize pain and anxiety with the lowest level of sedation to be applied. There is no standard recommendation for sedation and analgesic drug selection in trauma patients. Short-acting and reversible agents should be preferred. The most commonly used sedative agents are dexmedetomidine and midazolam; analgesic drugs are acetaminophen, fentanyl and morphine. It is generally preferred to use a combination of benzodiazepines and opioids. It is extremely important to make optimal adjustments in the selection of sedative and analgesic agents and dose adjustments in trauma patients that will not interfere with the neurological monitoring of the patient. Physical examination alone is insufficient for neurological evaluation, and the combined use of various sedation scales can provide a more objective evaluation.
Keywords: Analgesia; sedation; pediatrics; trauma; nervous system

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