Sedation And Analgesia Challenges In Critically Ill Neonates And Children

The anesthesia and intensive care in infants and children have assumed positions of primary importance in contemporary medicine. In these delicate sectors of medicine, clinical research activities must be continually supported by interdisciplinary collaborations. Neonatal and pediatric intensive care requires that all involved physicians, including the surgeon and anesthesiologist, be willing to work together as a team. However, coordination of the various pathophysiological and clinical aspects of neonatal and pediatric critical medicine is highly complex. A complete and current review of the anaethesia and intensive care of infants and children must include discussions of morbidity rates, so as to guide the clincians in choosing the diagnostic approach, as well as of monotoring techniques appropriate to support the therapeutic decision. Recent progress in intensive care medicine for infants and children has been significant.

This book provides a comprehensive overview on sedation and analgesia for the pediatric intensivist. Divided into two primary sections, the text presents a framework on how to care for patients who need sedation, analgesia, and neuromuscular blockade inside the pediatric ICU (PICU), and how to manage procedural sedation in an outpatient setting. The first section focuses on sedation and analgesia for the critically ill child, with an emphasis on analgesics, sedatives, neuromuscular blockade, tolerance and withdrawal, and the PICU environment. The second section centers around procedural sedation, detailing patient selection, pre-sedation assessment, how to choose a sedation regimen, available agents, and nursing considerations. Written by experts in the field, Sedation and Analgesia for the Pediatric Intensivist: A Clinical Guide is a valuable resource for the pediatric intensivist in caring for their patients both inside and outside the PICU.

This book provides a comprehensive overview of current standards of anesthesia and intensive care in neonates and children, with a view to promoting standardization in clinical practice. The first part of the book, devoted to issues in intensive care, opens by considering scoring systems for the assessment of sick children. The diagnosis, prevention, and management of ventilator-associated pneumonia are then discussed, and the roles of high-frequency oscillatory ventilation and noninvasive respiratory support are reviewed. Further chapters address procedural sedation and analgesia in children, the progress toward ‘open’ ICUs with liberal visiting policies, and advances in long-term home mechanical ventilation. In the second part of the book, a range of important topics in anesthesia and perioperative medicine are discussed. After a review of safety issues, current trends in pediatric regional and locoregional anesthesia are described and a synopsis is provided on current knowledge regarding the use of central blocks in infants and children. Subsequent chapters are devoted to awareness monitoring, single-lung ventilation techniques, anesthesia in the context of severe prematurity, and emergence delirium. Pediatric Anesthesia, Intensive Care and Pain: Standardization in Clinical Practice will be an extremely useful source of information for both novices and more experienced practitioners in the field.

A concise, practical handbook giving up-to-date, evidence based, 'how to' guidance on safe, effective procedural sedation.

A practical, comprehensive guide to the special needs of infants and neonates undergoing anesthesia.

Pain Assessment and Pharmacologic Management, by highly renowned authors Chris Pasero and Margo McCaffery, is destined to become the definitive resource in pain management in adults. It provides numerous reproducible tables, boxes, and figures that can be used in clinical practice, and emphasizes the benefits of a multimodal analgesic approach throughout. In addition, Patient Medication Information forms for the most commonly used medications in each analgesic group can be copied and given to patients. This title is an excellent resource for nurses to become certified in pain management. Presents best practices and evidence-based guidelines for assessing and managing pain most effectively with the latest medications and drug regimens. Features detailed, step-by-step guidance on effective pain assessment to help nurses appropriately evaluate pain for each patient during routine assessments. Provides reproducible tables, boxes, and figures that can be used in clinical practice. Contains Patient Medication Information forms for the most commonly used medications in each analgesic group, to be copied and given to patients. Offers the authors' world-renowned expertise in five sections: Underlying Mechanisms of Pain and the Pathophysiology of Neuropathic Pain includes figures that clearly illustrate nociception and classification of pain by inferred pathology. Assessment includes tools to assess patients who can report their pain as well as those who are nonverbal, such as the cognitively impaired and critically ill patients. Several pain-rating scales are translated in over 20 languages. Nonnopioids includes indications for using acetaminophen or NSAIDs, and the prevention and treatment of adverse effects. Opioids includes guidelines for opioid drug selection and routes of administration, and the prevention and treatment of adverse effects. Adjuvant Analgesics presents different types of adjuvant analgesics for a variety of pain types, including persistent (chronic) pain, acute pain, neuropathic pain, and bone pain. Prevention and treatment of adverse effects is also covered. Includes helpful Appendices that provide website resources and suggestions for the use of opioid agreements and for incorporating pain documentation into the electronic medical record. Covers patients from young adults to frail older adults. Provides evidence-based, practical guidance on planning and implementing pain management in accordance with current TJC guidelines and best practices. Includes illustrations to clarify concepts and processes such as the mechanisms of action for pain medications. Features spiral binding to facilitate quick reference.

A new edition of a highly regarded text in the series on Pain Research and Clinical Management. The book is now used as a standard reference text for those working in the field of neonatology and paediatric pain assessment and management. It provides a comprehensive resource of the latest information in the field for use by both researchers and clinicians. The text is intended for use by all professionals working in the field: neonatologists; pediatricians; anestheiologists; nurses; psychologists. Multidisciplinary editorship and authorship ensuring relevancy and balance of content for all professional groups concerned. Clinically relevant and research based. Edited and written by the best known international names in the field. Covers pain management in infants up to 1 year of age as well as term and preterm neonates. Includes new chapters on: Long-term consequences of neonatal pain from animal models; Pharmacogenetics and pharmacodynamics of analgesic drugs; Neuraxial and Regional Analgesia and Anesthesia; Fetal pain and surgery; Vulnerable Populations, Palliative Care; Infant Pain in the Home and Community, Developing Countries; Health Policy and Health Economics related to Infant Pain; Complementary and Alternative Approaches to Pain in Infancy; and Future Direction.