危重儿童常用镇静镇痛评估方法

绝大多数PICU患儿都会接受镇静镇痛治疗,无论是过度还是不足均会导致不良反应.自我评估是疼痛评估的“金标准”,但常需结合行为和生理学指标进行判断.镇静镇痛评估方法繁多,但各有利弊,理想的评估方法应该简单、实用、可重复性好；但是目前尚无一种被大家完全接受的客观评估方法,也没有一种方法能适用于所有年龄段及不同病情的患儿.因此,临床医师需根据不同的环境、病情、患者特点等选择适宜的评估方法,甚至需要不同的方法相结合,最终指导治疗.

The assessment of sedation and analgesia in critical children

Nearly every patient admitted into PICU is administered sedation and analgesia therapy.The precise control of the depth of sedation and the intensity of pain are often not well managed.Inappropriate treatment will cause more adverse effects.Self-assessment is considered the ＆quot;gold standard＆quot; in pain rating,other complementary methods being the behavioural measures and the biological measures,that reflect the body＆#39;s answer to pain.There is a growing need for reliable and valid sedation and pain instruments that can easily be incorporated into daily care.There are many methods for assessing pain and sedation in critical children,but none is completely accepted as an objective measure or suitable for all ages of children.The clinicians should choose appropriate assessment tools and even combine different tools according to the environment,condition and the characteristics of patients.