Strategies for treatment of withdrawal
o gradual wean
o conversion to long acting enteral medications (i.e.
methadone, clonidine, lorazepam),
o addition of dexmedetomidine infusion as an adjunctive
medicationVIII. Pain and Sedation Assessment Tools
A. WAT-1 [18]^
Withdrawal Assessment Tool, which is an 11 - item symptom assessment
of opioid and benzodiazepine withdrawal focusing on motor, behavioral
state, autonomic disturbances, and gastrointestinal symptoms. WAT- 1
has been studied and validated in a multicenter prospective trial by
Franck and Curley. (Table 5)
12 point scale. Score 0- 12
Start scoring on first day of weaning, perform twice daily
Score of 3 or higher had best sensitivity and specificity of clinically
significant withdrawal