Introduction to Sedation and Analgesia

Abstract

While the history of analgesia and sedation is relatively short in years, it has been rife with changes and discoveries. The history of critical care practice arose from the realm of anesthesiology with significant advances occurring during the polio pandemic, whereas neonatal tetanus spurred much of pediatric and neonatal critical care development. Initial descriptions of critical care practice held little description of sedation and analgesia practices. In more recent years, the importance of this has been increasingly appreciated. We have a better understanding of the sources of pain and anxiety and adverse effects of undertreated pain in children, dispelled myths surrounding pain management in pediatric and neonatal patients, and increased our incorporation of the impact of disease or comorbid states on the pharmacokinetic properties of sedative and analgesic agents in the critically ill. Consequently, appropriate sedation and analgesia should be a priority in the management of any critically ill child.