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[Analgesia and sedation of ventilated patients in intensive care medicine].
Any patient admitted to an intensive care unit requires individual analgetic and sedative treatment, depending on type and severity of the disease with its associated physical and psychic problems. There is a wide range of possible medicaments and combinations of these from among which the authors investigated combinations of the short-action opiates fentanyl and alfentanyl and midazolam, a benzodiazepine, short-action as well. These were tested for their effects on several circulatory parameters, intracranial pressure, wake-up behaviour, and selected hormonal parameters of mechanically ventilated patients. Both analgosedation schemes yielded best results, when compared to other combinations also continuously administered through perfusion. Individually adapted synchronisation of the patients to respirator and therapeutic concept proved to be practicable at any time, in spite of that fixed combination of analgetic with sedative.
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