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Published on: July 4, 2018

Practice of analgesia and sedation in Italian Paediatric Intensive Care Units: did we progress?

A Amigoni1, I Catalano, E Vettore

  • 1Department of Pediatrics, University of Padua, Padua, Italy. amigoni@pediatria.unipd.it

Minerva Anestesiologica
|October 4, 2012
PubMed

Insights

Pediatric intensivists in Italy commonly use opioid and benzodiazepine combinations for analgesia and sedation. While practices have improved, adherence to international guidelines for sedation assessment and withdrawal monitoring in pediatric intensive care units remains incomplete.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pain Management
  • Sedation Practices

Background:

  • Limited guidelines exist for analgesia and sedation management in critically ill children.
  • Current practices in Italian Pediatric Intensive Care Units (PICUs) require description and evaluation against pediatric guidelines.

Purpose of the Study:

  • To describe current analgesia and sedation practices in Italian PICUs.
  • To assess adherence to the latest pediatric guidelines for sedation and analgesia in critically ill children.

Main Methods:

  • A questionnaire survey was distributed to 24 Italian PICUs in 2010.
  • All contacted centers (100%) completed and returned the questionnaire.

Main Results:

  • All Italian PICUs utilize a combination of opioid and benzodiazepine for analgesia and sedation.
  • Sedation levels are regularly monitored in 50% of centers, but only 37% use validated tools.
  • Withdrawal syndrome is monitored in 25% of PICUs, with the Finnegan scale being the sole method used.

Conclusions:

  • Italian pediatric intensivists share a consistent drug strategy for analgesia and sedation, aligning with guidelines.
  • While sedation assessment is more widespread, it's not consistently performed using validated tools.
  • Monitoring for withdrawal syndrome occurs in a minority of centers, indicating room for improvement in adherence to international recommendations.
Abstract

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