Sedation, Analgesia and Cerebral Protection After Cardiac Surgery

The majorities of patients admitted to the unit are post-surgical and will have a median sternotomy or lateral thoracotomy which will be painful. Other pediatric care intensive care unit (PCICU) experiences may also be unpleasant, such as the presence, insertion or removal of chest drains, tracheal tubes, lines, physiotherapy, and suction. Adequate analgesia and sedation are therefore required, and many PCICU favor the use of a Fentanyl infusion, supplemented by bolus doses of Fentanyl and/or Midazolam infusion. Accumulation of these drugs and their metabolites will occur with prolonged use, so sedation and analgesia must be reviewed regularly.