Protocolo de analgesia e sedação

Abstract

OBJECTIVE: The overall objective of this study was to develop an institutional protocol for the management of sedation and analgesia in critically ill adult patients admitted to an intensive care unit. METHOD: A narrative review on analgesia and sedation in critically ill adult patients was conducted using the descriptors: "pain," "analgesia," "sedation," and "critically ill patient." The databases used were PubMed and UpToDate. Articles, protocols, and guidelines in English, Spanish, and Portuguese, published between 2020 and 2025, were selected if they addressed analgesia and sedation in critically ill adults in their title, abstract, or body of the text. Duplicate articles, case reports, and articles lacking information on the subject were excluded. Following the narrative review, an institutional protocol for sedation and analgesia in critically ill adult patients was developed for consultation in the ICU setting of HC-UFU, in accordance with the standards of the Quality Management Unit. RESULTS: Patient assessment and reassessment regarding pain, suffering, and anxiety using scales and following protocols with pharmacological and non-pharmacological treatment reduces length of stay, suffering, and negative experiences during hospitalization, in addition to facilitating the work of the multidisciplinary team. The ideal strategy for acute pain management consists of multimodal therapy to increase efficacy and reduce opioid use and side effects. Sedation is used in selected cases requiring specific goals and continuous patient reassessment to achieve the lowest possible dose and duration of use, reducing morbidity and other complications. According to the most current studies and guidelines, prioritizing analgesia first and maintaining light sedation, both guided by goals, is the best method for managing and caring for critically ill patients, standardizing and guiding the work of each healthcare professional within their area of expertise for timely recovery, reducing morbidity and mortality associated with hospitalization. CONCLUSION: The sedation and analgesia protocol for critically ill adult patients at HC-UFU was developed and submitted for publication, based on the best available scientific evidence and adapted to institutional practice. In this way, the standardization of actions by professionals, faculty, and students working in the adult ICU regarding the management of analgesia and sedation of critically ill patients was made possible.

Keywords: Pain; Analgesia; Sedation; Critically ill.