Sedoanalgesia con midazolam-ketamina en el paciente crítico ventilado mecánicamente

Jonathan Mauricio Quisilema Cadena; Idoris Cordero Escobar; Obdulio González Hernández

Sedoanalgesia con midazolam-ketamina en el paciente crítico ventilado mecánicamente

Jonathan Mauricio Quisilema Cadena, Idoris Cordero Escobar, Obdulio González Hernández

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Resumen

La sedoanalgesia en pacientes bajo ventilación mecánica artificial se recomienda para lograr una mejor satisfacción del paciente y prevenir complicaciones. El objetivo de este trabajo fue realizar una revisión bibliográfica sobre la acción sedoanalgésica de la combinación de midazolam-morfina comparado con midazolam-ketamina en pacientes críticos tratados con ventilación mecánica artificial. Se realizó una búsqueda manual y digital en diferentes bases de datos como Scielo, IBECS, MEDLINE, Google Scholar, Cochrane y Wh, con los descriptores en inglés siguientes: sedation, midazolam-ketamine, midazolam-morfina AND mechanical ventilation AND crtical illness "[MeSH Terms]. Se encontró un total de 60 artículos, todos realizados en seres humanos, 32 en los últimos 5 años, pero solo 16 a texto completo. De ellos, 7 eran revisiones sistemáticas sobre el tema y solo 4 ensayos clínicos. Ninguno utilizó la asociación midazolam-ketamina para la sedación. En la revisión realizada no se encontró ningún artículo que informara sobre las ventajas de la asociación midazolam-ketamina en la sedación del paciente crítico ventilado mecánicamente, lo que le confiere novedad a la investigación.

Palabras clave

Sedación; midazolam-ketamina; midazolam-morfina; ventilación mecánica; pacientes críticos

Referencias

Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology. 2009;111:1308-16.

Richman PS, Baram D, Varela M, Glass PS. Sedation during mechanical ventilation: a trial of benzodiazepine and opiate in combination. Crit Care Med. 2006;34:1395-401.

Oliver WC, Nuttall GA, Murari T, Bauer LK, Johnsrud KH, Hall Long KJ, et al. A prospective, randomized, double-blind trial of 3 regimens for sedation and analgesia after cardiac surgery. J Cardiothorac Vasc Anesth. 2011;25:110-9.

Celis-Rodríguez E, Birchenall C, de la Calc MÁ, Castorena Arellanod G, Hernández A, Cerasoet D, et al. Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo. Med Intensiva. 2013. Disponible en: http://dx.doi.org/10.1016/j.medin.2013.04.001

Adeline Fong A, Schug SA. Pathophysiology of pain: A practical primer. Plastic Reconst Sur. 2014;134:4S-2.

Daenen L, Varkey E, Kellmann M, Nijs J. Exercise, not to exercise, or how to exercise in patients with chronic pain? Applying science to practice. Clin J Pain. 2015;31:108-14.

Hina N, Fletcher D, Poindessous-Jazat F, Martinez V. Hyperalgesia induced by low-dose opioid treatment before orthopaedic surgery: An observational case-control study. Eur J Anaesth. 2015;32:255-61.

Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41:263-306.

De Grado JR, Anger KE, Szumita PM, Pierce CD, Massaro AF. Evaluation of a local ICU sedation guideline on goal-directed administration of sedatives and analgesics. J Pain Res. 2011;4:127-34.

Rosero EB, Joshi GP. Preemptive, preventive, multimodal analgesia: what do they really mean? Plastic Reconst Sur. 2014;134:4S-2.

Hui Low Y, Gan TJ. NMDA Receptor Antagonists, Gabapentinoids, α-2 agonists, and dexamethasone and other non-opioid adjuvants: do they have a role in plastic surgery? Plastic Reconst Sur. 2014;134:48-52.

Iakovou A, Wong Lama KM, Tsegaye A. Update on sedation in the critical care unit. Open Crit Care Med J. 2013;6(Suppl. 1:M5):66-79.

Reade MC, Finfer S. Sedation and delirium in the intensive care unit. N Engl J Med. 2014;370:444-54.

Martel JP, Barnett ShR. Sedation: definitions and regulations. Int Anesth Clin. 2015;53:1-12.

Sessler CN, Grap MJ, Ramsay MA. Evaluating and monitoring analgesia and sedation in the intensive care unit. Crit Care. 2008;12(Suppl 3):S2.

Crimi C, Bigatello LM. The clinical significance of delirium in the intensive care unit. Translational Medicine. 2012;2(1):1-9.

Levy MM. Pathophysiology of oxygen delivery in respiratory failure. Chest. 2010;137:547-53.

Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974;2:656-9.

Riker RR, Picard JT, Fraser GL. Prospective evaluation of the Sedation Agitation Scale for adult critically ill patients. Crit Care Med. 1999;27:1325-9.

Kiekkas P, Samios A, Skartsani C, Tsotas D, Baltopoulos GI. Fever and agitation in elderly ICU patients: a descriptive study. Intensive Crit Care Nurs. 2010;26:169-74.

Vasilevskis EE, Han JH, Hughes ChG, Wesley Ely E. Epidemiology and risk factors for delirium across hospital settings. Best Pract Res Clin Anaesthesiol. 2012;26:277-87.

Reade MC, Finfer S. Sedation and delirium in the intensive care unit. N Engl J Med. 2014;370:444-54.

Shehabi Y, Riker RR, Bokesch PM, Wisemandle W, Shintani A, Ely EW. Delirium duration and mortality in lightly sedated, mechanically ventilated intensive care patients. Crit Care Med. 2010;38:2311-8.

Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomized trial. Lancet. 2010;375:475-80.

Mirski MA, Lewin JJ, Ledroux S, Thompson C, Murakami P, Zink EK, et al. Cognitive improvement during continuous sedation in critically ill, awake and responsive patients: the Acute Neurological ICU Sedation Trial (ANIST). Intensive Care Med. 2010;36:1505-13.

Augustes R, Ho KM. Meta-analysis of randomized controlled trials on daily sedation interruption for critically ill adult patients. Anaesth Intensive Care. 2011;39:401-9.

Morandia A, Brummel NE, Wesley Elya E. Sedation, delirium and mechanical ventilation: the A B C D E' approach. Curr Opin Crit Care. 2011;17:43-9.

Khodayari-Rostamabad A, Olesen SS, Graversen C, Malver LP, Kurita GP, Sjøgren P, et al. Disruption of cortical connectivity during remifentanil administration is associated with cognitive impairment but not with analgesia. Anesthesiology. 2015;122:140-9.

Page V, McAuley DF. Sedation/drugs used in intensive care sedation. Curr Opin Anaesth. 2015;28:139-44.

Needham DM, Korupolu R, Zanni JM, Pradhan P, Colantuoni E, Palmer JB, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil. 2010;91:536-42.

Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, et al. Dexmedetomidinevs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA. 2012;307:115160.

Wunsch H, Kahn JM, Kramer AA, Wagener G, Li G, Sladen RN, et al. Dexmedetomidine in the care of critically ill patients from 2001 to 2007: an observational cohort study. Anesthesiology. 2010;113:386-94.

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