Avaliação da sedoanalgesia pelo monitoramento do índice bispectral em uma Unidade de Terapia Intensiva Covid: a importância das intervenções farmacêuticas

Patrícia Nunes dos Santos; Jeamile Lima Bezerra; Tairo  Janilson César de Oliveira; Patricia Bastos do Nascimento; Laisa Lis Fontinele de Sá; Lubna Karine Beserra Santos; Ronaby Ferreira Sousa Silva

doi:10.47456/rbps.v25i2.40853

Authors

Patrícia Nunes dos Santos UNIVERSIDADE FEDERAL DO PIAUI https://orcid.org/0000-0002-7173-2116
Jeamile Lima Bezerra https://orcid.org/0000-0002-6416-8772
Tairo Janilson César de Oliveira https://orcid.org/0000-0003-3822-5734
Patricia Bastos do Nascimento https://orcid.org/0000-0002-1705-0894
Laisa Lis Fontinele de Sá
Lubna Karine Beserra Santos https://orcid.org/0000-0003-1205-1190
Ronaby Ferreira Sousa Silva https://orcid.org/0009-0003-4051-8939

DOI:

https://doi.org/10.47456/rbps.v25i2.40853

Keywords:

Sedatives, Analgesics, Covid-19, Awareness monitors, Clinical Pharmacists

Abstract

Introduction: The bispectral index (BIS) is a monitor of the level of consciousness with greater sensitivity and objectivity for the evaluation of brain activity compared to the usual subjective scales, mainly the RASS (Richmond Agitation-Sedation Scale), during comatose states. Objectives: To evaluate sedoanalgesia and the levels of consciousness of patients on mechanical ventilation through BIS monitoring. Methods: The research is exploratory, cross-sectional and retrospective, conducted in patients of the ICU-Covid of the University Hospital of Federal do Piauí (HU-UFPI). Data were collected from June to December 2021, using data from BIS medical records and forms, after approval by the ethics committee (opinion 5,427,074). Analyzes were performed with simple descriptive statistics in Microsoft Excel. Results: We analyzed 121 evaluations in 47 patients, with 67% being men. Fentanyl and midazolam were the main analgesics and sedatives. About 60% of patients were deeply sedated and only 31% had adequate levels of sedoanalgesia by BIS. Comparing BIS and RASS, 67 analyzes had BIS 0-39 and RASS -5. About 80% had an overdose of midazolam and 29% of fentanyl. Pharmaceutical interventions contributed to reducing the use of sedoanalgesia. Conclusion: The BIS proved to be an effective tool in the assessment of sedoanalgesia and allowed a greater participation of the pharmacist in clinical practice. Its benefits included better drug control and adequacy of sedation in patients under mechanical ventilation in the Covid-ICU at HU-UFPI.

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