La sédation-analgésie au quotidien: Enquête de pratiques auprès de 218 services de réanimation en France

Translated title of the contribution: Current use of sedation and analgesia: 218 resuscitations in France services practices survey

J. M. Constantin, G. Chanques, B. De Jonghe, P. Sanchez, J. Mantz, J. F. Payen, F. Sztark, P. Richebé, F. Lagneau, X. Capdevila, J. E. Bazin, J. Y. Lefrant

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To assess the current use of sedation and analgesia in a large sample of French intensive care units (ICUs) and to define structural characteristics of the units that use a written procedure. Study design: Self-reported survey. Participants: Three hundred and sixty French ICUs were presented the questionnaire in September 2007. Results: Surveys were received from 228 (60.6%) ICUs. Midazolam was used in more than 50% of the patients in 79.2% of the ICUs and propofol in 22.2% of the ICUs. Sufentanil was the most frequently used morphinic. A sedation-scale was used in 68.8% of the units (80.3% Ramsay score). Sedation was assessed at least every 4. hours in 61% of ICUs. A pain-scale was used in 88.9% of the ICUs, but only 12.5% in the non-communicant patients. A written procedure was used in 29.4% of the units only. In multivariate analysis, use in the ICU of a written procedure for the early management of patients with septic shock and/or intensive insulin therapy was the single variable significantly associated with presence of a written procedure for sedation and analgesia (respectively OR 4.37; p<0.0001 and OR 5.64; p=0.032). Conclusion: Although more than two-third of the responding ICUs reported the use of sedation-and-pain-scales, frequency of assessment was low, and objective assessment of pain in the non-communicating patients was extremely uncommon. Similarly, the use of written procedure was low. The use of sedation-analgesia written procedure in an ICU seems strongly influenced by a more global involvement of the ICU in the protocolisation of complex care. These findings support the reinforcement of educational programs.

Translated title of the contributionCurrent use of sedation and analgesia: 218 resuscitations in France services practices survey
Original languageFrench
Pages (from-to)339-346
Number of pages8
JournalAnnales francaises d'anesthesie et de reanimation
Volume29
Issue number5
DOIs
StatePublished - May 1 2010

Keywords

  • Analgesia
  • Intensive care unit
  • Mechanical ventilation
  • Sedation
  • Sedation algorithm
  • Septic shock
  • Visual analogous scales

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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