Semin Respir Crit Care Med 2013; 34(02): 189-200
DOI: 10.1055/s-0033-1342973
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation and Treatment of Pain in Critically Ill Adults

Aaron M. Joffe
1   Department of Anesthesiology and Pain Medicine, University of Washington/Harborview Medical Center, Seattle, Washington
,
Matt Hallman
1   Department of Anesthesiology and Pain Medicine, University of Washington/Harborview Medical Center, Seattle, Washington
,
Céline Gélinas
2   Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
,
Daniel L. Herr
3   Shock Trauma Center, Division of Critical Care Medicine, University of Maryland, Baltimore, Maryland
,
Kathleen Puntillo
4   Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, California
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Publikationsdatum:
28. Mai 2013 (online)

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Abstract

Pain is experienced by the overwhelming majority of patients during their intensive care unit stay, but it remains an underappreciated problem. To effectively treat pain, it must be detected and quantified using a validated assessment tool. It is acknowledged that optimal pain relief may be difficult to achieve given the complex interplay of coexisting medical conditions and the environment in which care is provided. Nonetheless, by following structured approaches to pain, resource consumption may be reduced, and even improved survival may be realized. This review covers practices and techniques specific to addressing and treating pain in the adult intensive care environment. Traditional pharmacological approaches including opiate and nonopiate medications are reviewed, as are regional anesthetic techniques and nonpharmacological approaches used for controlling pain.