Process Management of Analgesia and Sedation Can Reduce the Incidence of Delirium

Abstract

Background: Critical patients in ICU have to experience pain, anxiety, and sleep deprivation which always cause delirium, which will prolong the hospital stay and come up with higher mortality. Analgesia based sedation can reduce the accumulation of sedative effects, and shorten ventilator time and ICU length of stay. Process management of analgesia and sedation can reduce the incidence of delirium. Objectives: To explore the clinical benefits of procedural analgesia and sedation for critical ill patients. Methods: This is a prospective, two-phase study that focuses on patients who required mechanical ventilation after surgery. Comparing patients’ pain and agitation scores, the species and dosage of sedative and analgesic, the incidence of delirium in the observation period and intervention period, data in two groups were collected and analyzed. Results: During the observational and interventional periods, we enrolled 213 patients before protocol implantation and 196 patients after protocol implantation. We found that there existed impropriate pain and sedation assessment in patients involved, and after training for procedural protocol, the average dosage of sedatives was decreased ( p > 0.05). The percentage of reaching standard COPT score was 73.7% vs 84.1% ( p > 0.05) and RASS score was 70.9% vs 79.6% ( p > 0.05) in the observation period and intervention period, and the incidence of delirium was significantly reduced (31.9% vs 23.5%, p < 0.05). Conclusion: We concluded that protocol implantation of analgesia and sedation can reduce the incidence of delirium.