Just as the concept of the “triad of anesthesia” underscores the pharmacodynamic interactions among hypnotics, analgesics, and muscle relaxants and the recognition that the simultaneous administration of agents of each class permits the use of lower doses of drugs of all classes, the concept of the “ICU triad” recognizes that pain, agitation, and delirium and therefore approaches to their management are inextricably linked (Figure 1FIGURE 1
Causes and Interactions of Pain, Agitation, and Delirium.
). According to the principle that it is better to treat disease than to mask it, sedatives should be used only when pain and delirium have been addressed with the use of specific pharmacologic and nonpharmacologic strategies.
Just as the concept of the “triad of anesthesia” underscores the pharmacodynamic interactions among hypnotics, analgesics, and muscle relaxants and the recognition that the simultaneous administration of agents of each class permits the use of lower doses of drugs of all classes, the concept of the “ICU triad” recognizes that pain, agitation, and delirium and therefore approaches to their management are inextricably linked (Figure 1FIGURE 1Causes and Interactions of Pain, Agitation, and Delirium.). According to the principle that it is better to treat disease than to mask it, sedatives should be used only when pain and delirium have been addressed with the use of specific pharmacologic and nonpharmacologic strategies.
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