Impact of the implementation of a sedoanalgesia protocol in a pediatric intensive care unit

Introduction. Adequate sedation and analgesia is essential in the treatment of patients who require mechanical ventilatory assistance (MVA). The use of protocols and their monitoring is recommended; The results reported on adhesion and impact are disparate. Objectives. To evaluate the impact of the implementation of a sedoanalgesia protocol on the use of benzodiazepines, opioids and evolution in the pediatric intensive care unit (PICU), in patients requiring AVM greater than 72 hours. Methods. Uncontrolled before-after study in the PICU of a pediatric hospital. It was developed in 3 stages: pre-intervention of situational diagnosis (from April to September 2019), intervention and post-intervention of implementation of the sedoanalgesia protocol, education on use and monitoring of adherence and its impact (from October 2019 to October 2021). Results: 99 and 92 patients entered the study in the pre- and post-intervention stages, respectively. They had greater severity, lower age and weight in the pre-intervention period. In the comparison of groups, after adjusting for severity and age, in the post-intervention stage a reduction was reported in the days of continuous infusion opioid use (6 +/- 5.2 vs. 7.6 +/- 5.8; p = 0.018) and the days of use of benzodiazepines in continuous infusion (3.3 +/- 3.5 vs. 7.6 +/- 6.8; p = 0.001). No significant differences were observed in days of AVM and total days of benzodiazepine use. Conclusion. The implementation of a sedoanalgesia protocol made it possible to reduce the use of continuous infusion drugs.