SIAARTI Reccomandations for analgo-sedation in intensive care unit.

The aim of these guidelines is to reduce the variety of analgesic and sedation procedures in intensive care units (ICU) so to assure the patient the fulfillment of the right to analgesia and reach an adequate state of sedation with complete control over possible side effects and maximizing the beneficial effects of all the techniques adopted during the days of artificial ventilation and the whole stay in the ICU. It is really very relevant to control diurnal rhythm, delirium and psychiatric symptoms associated and procedural pain. It seems important to underline that the inversion of word order from “sedation-analgesia” to “analgo-sedation” corresponds to a different cultural attitude which recognizes, even in the ICU, the interruption of the neuroendocrine/ metabolic cascade as the starting point which takes place when there is pain, and that could be followed, using the appropriate drugs, by the control of the anxious component or that could be laid on a certain level of hypnosis. This will help to prevent the appearance of post-traumatic stress disorder (PTSD), “the development of typical symptoms that follow the exposure to an extremely traumatic stressful event which involves direct personal experience; the event could concern the real risk of death or of a severe lesion or of any other danger which encroaches on physical integrity”.