Sedative Agents in Critical Care

Study Notes

Sedative Agents Overview

Common treatments for anxiety in critical care include benzodiazepines, propofol, and dexmedetomidine.
Patients in critical care may experience both pain and anxiety, potentially with psychotic features such as delirium.

Benzodiazepines

Classified as sedatives and hypnotics but lack analgesic properties.
Elderly patients or those with renal or hepatic insufficiency may have slower benzodiazepine clearance, leading to prolonged effects.
Continuous infusions require monitoring to prevent over-sedation.

Propofol

An intravenous general anesthetic used for sedation; requires special access for continuous infusion to prevent infection.
Possesses rapid onset and short duration of action.
No analgesic properties; potential adverse effects include hypotension, bradycardia, and increased triglyceride levels.
High-dose infusions can lead to metabolic acidosis or dysrhythmias, and the maximum hanging time is 12 hours.
Should be considered a caloric source when administered due to its lipid content.

Neuromuscular Blockade (NMB) Agents

NMB agents do not provide sedative or analgesic effects; muscle relaxants facilitate intubation, ventilation, and bedside procedures.
Patients on NMB agents must also be sedated, often starting continuous sedative infusions prior to NMB administration.
Pain or anxiety during NMB can result in elevated heart rate and blood pressure responses.
Patients lose voluntary muscle movement, communication, and the ability to breathe independently when on NMB.

Description

This quiz focuses on the use of sedative agents such as benzodiazepines, propofol, and dexmedetomidine in managing anxiety and pain in critical care settings. It covers the implications of psychotic features and the administration of neuroleptics and antidepressants. Ideal for healthcare professionals and students seeking to understand sedation protocols.