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Critically ill neonates and children frequently require sedation and analgesia. Although these treatments are necessary to alleviate pain and anxiety, they are associated with issues such as tachyphylaxis, withdrawal, possible association with delirium, potential long-term effects especially in developing ...

Critically ill neonates and children frequently require sedation and analgesia. Although these treatments are necessary to alleviate pain and anxiety, they are associated with issues such as tachyphylaxis, withdrawal, possible association with delirium, potential long-term effects especially in developing brains, etc. In addition, there is an important heterogeneity in the way sedation and analgesia are administered, each institution developing their own strategies. Moreover, little is known about the efficacy of non-pharmacological treatments. Therefore, sedation and analgesia are a daily challenge in neonatal and pediatric critical care.

The objective of this Research Topic is to address the various challenges of sedation and analgesia in critically ill neonates and children. Despite a myriad of drugs and non-pharmacological approaches to sedation and analgesia, we struggle every day to find the optimal balance between under- and oversedation, as well as efficacy and safety regarding pain and analgesia. New developments related to pain and sedation assessment may provide better options to monitor sedation and pain. Model-informed dosing may provide individualized drug treatment. We wish to address these and other aspects of sedation and analgesia in critically ill neonates and children, such as sedation and pain assessment, new molecules, tiered sedation strategies, pharmacokinetics, weaning strategies, withdrawal and delirium, long-term impact, non-pharmacological therapies (hypnosis, acupuncture, etc.). The aim of this topic is to provide clinicians and researchers with an overview of state-of-the-art knowledge on this topic to directly improve patient care and to generate new research ideas.

The scope of this article collection is the assessment and treatment for sedation and analgesia in critically ill children. We welcome in-vitro studies and animal models, clinical studies, including pharmacokinetic studies, reviews, pro-con debates, quality improvement projects, etc.

Keywords: critical illness; analgesia; sedation; weaning; delirium


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