ABSTRACT
Preliminary evidence suggests that closely monitoring sedation may have a positive
effect on patient outcomes, including reductions in intensive care unit (ICU) stay,
duration of mechanical ventilatory support, and number of diagnostic tests requested
to assess central nervous system function. In the last few years, subjective instruments
to assess agitation and sedation have been developed and tested for reliability and
validity, including the Sedation-Agitation Scale and the Motor Activity Assessment
Scale. Similar efforts directed to delirium among ICU patients have produced several
assessment tools to help clinicians with this difficult area of patient care. Promising
techniques for objective assessment of sedation (such as the bispectral index) and
strategies to guide neuromuscular blockade with train-of-four (TOF) or clinical exam
monitoring have emerged. Future efforts should focus on evaluating the impact of these
monitoring techniques on specific outcomes in an effort to improve patient comfort,
minimize adverse events, and reduce resource consumption.
KEYWORD
Sedation - reproducibility of results - analgesia
