Sedation, analgesia, and neuromuscular paralysis

Comfortable patient; ethical and good medical practice. Relieves pain, anxiety, recall; enhances patient safety. Mandated in 2000 by The Joint Commission. Sedation may be particularly difficult to titrate in neurologically compromised patient. Sedatives and analgesics may compromise exam and cerebral physiology. More need for conscious sedation due to recent reduction in pharmacologically induced paralysis in ICU patients. Emphasis on reducing length of ICU stay and cost of hospitalization. Guidelines stress minimizing depth and duration of sedative regimens; overall beneficial for neurologic patient, as more likely to preserve neurologic functions