Sedation & Analgesia Flashcards
What are the aims of sedation and analgesia?
Relieve anxiety
Relieve pain
Enhance toleration of intubation and ventilation
Allow procedures
Control intracranial pressure
What scoring system is used to measure sedation?
Richmond agitation sedation score.
-5 (unrousable) to +4 (overtly combative)
0 is alert and calm.
How should hyperactive delirium be treated?
Dexmedetomidine
Or
Quetiapine
Should not be suppressed with sedatives (benzodiazapines are associated with increased risk of delirium)
What are the advantages of propofol?
Does not produce tolerance (unlike benzos)
No withdrawal effects
Safe to use in renal failure.
Inexpensive
What are the disadvantages of propofol?
Not haemodynamically stable: reduces cardiac contractility and causes vasodilation.
Can therefore produce profound hypotension
Induction dose of propofol
1 mg/kg minimum for an alert, haemodynmically stable adult.
Rocuronium vs suxamethonium: time to onset, and length of effect.
Suxamethonium is faster.
Rocuronium takes longer and lasts longer
Rocuronium vs suxamethonium: reversibility
Rocuronium is reversible with sugammadex.
Rocuronium vs suxamethonium: side effects
Suxamethonium causes numerous side effects: bradycardia, K release, apnoea, hyperthermia.
Which muscle relaxant should be used in hyperkalaemic patients?
Rocuronium.
Suxamethonium is not safe in hyperkalaemia as it can lead to K release.
