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Updated: Apr 18, 2026
Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Sedation and analgesia in the ICU
Jill Zalieckas1, Christopher Weldon1
1Boston Children's Hospital, 300 Longwood Ave, Boston, Massachusetts 02115.
Insights
Optimizing sedation and analgesia in critically ill children is crucial. Establishing evidence-based algorithms can reduce morbidity and mortality associated with these essential treatments.
Area of Science:
- Pediatric Critical Care Medicine
- Pharmacology
- Pain Management
Background:
- Pain and anxiety management are vital for critically ill children.
- Sedation and analgesia are commonly used for procedures, mechanical ventilation, and overall care.
- Current data on optimal pediatric sedation/analgesia regimens and safety profiles are insufficient.
Purpose of the Study:
- To review sedative use in pediatric intensive care units (PICUs).
- To discuss the morbidity associated with sedatives and analgesics in children.
- To emphasize the need for sedation and analgesia algorithms to minimize harm.
Main Methods:
- Literature review of sedative and analgesic use in pediatric intensive care.
- Analysis of existing data on drug choices, dosing, and regimens.
- Examination of short- and long-term safety profiles in pediatric populations.
Main Results:
- Sedation regimens in PICUs lack comprehensive pediatric-specific data.
- Existing practices are associated with significant morbidity in critically ill children.
- There is a critical need for standardized, evidence-based protocols.
Conclusions:
- Sedation and analgesia are complex aspects of pediatric critical care.
- Morbidity linked to these agents necessitates careful management.
- Development of sedation and analgesia algorithms is essential for improving outcomes and reducing mortality.
Abstract:
The alleviation of pain and anxiety is an important component of caring for a critically ill child. Sedation and analgesia regimens are utilized as adjuncts to procedures, facilitate mechanical ventilation, and assist with management of a critically ill child. Although sedation regimens have been used extensively across intensive care units, the data are lacking as to the best drugs, dosing, regimens, and short- and long-term safety profiles for use in the pediatric population. Sedation regimens continue to be a challenging aspect of the care of a critically ill child, and they have been associated with significant morbidity in this population. This article will discuss the sedative use in the intensive care unit, morbidity associated with sedatives and analgesics, and the importance of establishing sedation and analgesia algorithms to reduce morbidity and mortality.
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