The 90% effective dose of a sufentanil bolus for the management of painful positioning in intubated patients in the ICU
European Journal of Anaesthesiology, 05/25/2012Chaveron D et al.
The effective dose in 90% was 0.15µgkg–1 during the first 5days of sedation. There were no adverse effects. A pre–emptive sufentanil bolus can be used to treat anticipated pain in the ICU. Regular and frequent assessments of acute pain and sedation are essential for adjusting the dose, on a case–by–case basis. This strategy may help clinicians to keep background infusions of sedatives and narcotics as low as possible and may improve clinical outcome.
Intubated and ventilated patients were eligible for the study once they had reached a BPS of 3 or 4 and Ramsay score of 3–5 within 48h of admission to the ICU.
The analgesic efficacy of a sufentanil bolus was measured during successive lateral decubitus positioning over a 72–h study period, using the BPS scale.
The dose was increased with each subsequent turn to lateral decubitus until a BPS score of 3–4 was obtained (dose escalation, starting at zero).
BPS, Ramsay score, heart rate and mean arterial pressure were collected before and during each procedure.
A total of 25 patients were enrolled over 6 months.
The ED90 bolus for sufentanil was 0.15µgkg–1, but 40% of the patients subsequently demonstrated increased BPS with this dose.
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