Sedation and pain control in the critically ill patient maintained on continuous neuromuscular blockade

Anxiety and pain pose a challenge in the management of the critically ill patient on continuous neuromuscular blockade. Without adequate treatment, anxiety can further complicate a patient's already compromised state. Benzodiazepines, haloperidol, and propofol provide options for anxiolysis in these patients. Despite the fact that the physiologic consequences of pain can be devastating, the undertreatment of pain remains an issue. The opioid agonists constitute the agents of choice for parenteral analgesia in the critically ill.