Paralytics are generally avoided because we know now that the use of them can cause muscle issues after the acute phase of illness is over. Generally speaking we use a sedative such as Propofol and Versed in combination with a pain medication such as Fentanyl. The ideal goal is to have an intubated pt awake enough to follow simple commands such as wiggle your toes or squeeze my hand, yet asleep enough to not be really uncomfortable. The reason for this is that patients do better in the long run if they aren't heavily sedated.....for multiple reasons.
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