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The 90% effective dose of a sufentanil bolus for the management of painful positioning in intubated patients in the ICU
European Journal of Anaesthesiology, 05/25/2012
Clinical Article
Chaveron D et al. – The effective dose in 90% was 0.15µgkg–1 during the first 5days of sedation. There were no adverse effects. A pre–emptive sufentanil bolus can be used to treat anticipated pain in the ICU. Regular and frequent assessments of acute pain and sedation are essential for adjusting the dose, on a case–by–case basis. This strategy may help clinicians to keep background infusions of sedatives and narcotics as low as possible and may improve clinical outcome.
Methods- Intubated and ventilated patients were eligible for the study once they had reached a BPS of 3 or 4 and Ramsay score of 3–5 within 48h of admission to the ICU.
- The analgesic efficacy of a sufentanil bolus was measured during successive lateral decubitus positioning over a 72–h study period, using the BPS scale.
- The dose was increased with each subsequent turn to lateral decubitus until a BPS score of 3–4 was obtained (dose escalation, starting at zero).
- BPS, Ramsay score, heart rate and mean arterial pressure were collected before and during each procedure.
- A total of 25 patients were enrolled over 6 months.
- The ED90 bolus for sufentanil was 0.15µgkg–1, but 40% of the patients subsequently demonstrated increased BPS with this dose.