SEDATION AND ANALGESIA IN PROCEDURES: INDICATIONS, PHARMACOLOGIC AGENTS, MONITORING, AND DISCHARGE CRITERIA – A LITERATURE REVIEW

Abstract

Sedation and analgesia are fundamental strategies for promoting comfort, safety, and success in invasive procedures, reducing pain, anxiety, and the risk of complications. This literature review aimed to analyze the main evidence on indications, drugs, monitoring, and discharge criteria, aiming to guide safe and effective clinical practices. The methodology consisted of a narrative review of the PubMed, Scopus, Web of Science, and SciELO databases, using Boolean operators and terms related to sedation, analgesia, and safety; clinical trials, systematic reviews, and guidelines were included, while case reports, animal studies, and articles without full access were excluded. The results indicate that the individualized choice of drugs, such as propofol, etomidate, midazolam, ketamine, and opioids, combined with continuous monitoring of ventilatory, hemodynamic, and neurological parameters, is crucial for the safety of the procedure, especially in elderly patients or those with comorbidities. Risk assessment, adequate team preparation, equipment availability, and careful definition of hospital discharge are essential to minimize adverse events. It is concluded that, although pharmacological and technical advances allow for effective sedation, gaps still persist regarding the standardization of protocols and discharge criteria, reinforcing the need for evidence-based guidelines to optimize clinical practice.