Subscribe to RSS
DOI: 10.1055/s-2001-13827
Pain in the Intensive Care Unit: Recognition, Measurement, Management
Publication History
Publication Date:
31 December 2001 (online)
ABSTRACT
There has been a resurgence in interest in the in-hospital management of pain, largely related to results of investigations into the role of analgesia in outcome and cost-efficiency. The traditional aim of analgesia as simply an altruistic goal has been supplanted by the goal of impacting on the altered physiology accompanying critical illness and trauma. Elucidation of the effect of pain and the accompanying stress response on pulmonary dysfunction in particular, but also on myocardial ischemia and coagulation, has suggested that the provision of adequate analgesia by time-honored methods may not in itself effect a reduction in morbidity without attention to the method of analgesic delivery and choice of agent.
KEYWORD
Analgesia - pulmonary dysfunction - myocardial ischemia
REFERENCES
- 1 Donovan M, Dillion P, McGuire L. Incidence and characteristics of pain in a sample of medical-surgical patients. Pain . 1987; 30 69-78
- 2 Desbiens N, Wu A, Broste S. Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med . 1996; 24 1953-1961
- 3 Dray A. Inflammatory mediators of pain. Br J Anaesth . 1995; 75 125-131
- 4 Jensen M P, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain . 1986; 27 117-126
- 5 Habibi S, Coursin D. Assessment of sedation, analgesia and neuromuscular blockade in the perioperative period. Int Anesthesiol Clin . 1996; 34 215-241
- 6 Larson M, Sessler D, Washington D. Pupillary response to noxious stimulation during isoflurane and propofol anesthesia. Anesth Analg . 1993; 76 1072-1078
- 7 Terai T, Yukioka H, Asada A. Pain evaluation in the intensive care unit. Reg Anesth Pain Med . 1998; 23 147-151
- 8 Breslow M J. Clinical implications of the stress response to surgery. In: Longnecker DE, Tinker JH, Morgan GE, eds. Principles and practice of anesthesiology 2nd ed. St. Louis, MO: Mosby Year Book 1998: 117-129
- 9 Michelson D, Gold P, Sternberg E. The stress response in critical illness. New Horiz . 1994; 2 426-431
- 10 Pflug A, Halter J. Effect of spinal anesthesia on adrenergic tone and the neuroendocrine responses to surgical stress in humans. Anesthesiology . 1981; 55 120-126
- 11 Kehlet H. The modifying effect of general and regional anesthesia on the endocrine-metabolic response to surgery. Reg Anesth . 1982; 7 S38
- 12 Kehlet H. The stress response to anesthesia: release mechanisms and modifying factors. Clinics in Anesthesiology . 1984; 2 315
- 13 Weissman C. The metabolic response to stress: an overview and update. Anesthesiology . 1990; 73 308-327
- 14 Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth . 1997; 78 606-617
- 15 Moller I, Dinesan K, Sondergard S. Effect of patient-controlled analgesia on plasma catecholamine, cortisol and glucose concentrations after cholecystectomy. Br J Anaesth . 1988; 61 160-164
- 16 Brodner G, Pogatzki E, Aken H. A multimodal approach to control postoperative pathophysiology and rehabilitation in patients undergoing abdominothoracic esophagectomy. Anesth Analg . 1998; 86 228-234
- 17 Grass J. The role of epidural anesthesia and analgesia in postoperative outcome. Anesthesiology Clinics of North America . 2000; 18 407-428
- 18 Rosenfeld B, Beattie C, Christopherson R. The effects of different anesthetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Anesthesiology . 1993; 79 435-443
- 19 Cook P, Davies M, Cronin D. A prospective randomized trial comparing spinal anesthesia using hyperbaric cinchocaine with general anesthesia for lower limb vascular surgery. Anaesth Intensive Care . 1986; 14 373-380
- 20 Christopherson R, Beattie C, Frank S. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Anesthesiology . 1993; 79 422-434
- 21 Mangano D T, Siliciano D, Hollenberg M. Postoperative myocardial ischemia: therapeutic trials using intensive analgesia following surgery. Anesthesiology . 1992; 76 342-353
- 22 Vanhoutte P M, Shimokawa H. Endothelium-derived relaxing factor and coronary vasospasm. Circulation . 1989; 80 1-9
- 23 Davis R, DeBoer L WV, Maroko P R. Thoracic epidural analgesia reduces myocardial infarct size after coronary artery occlusion in dogs. Anesth Analg . 1986; 65 711-717
- 24 Bonnet F, Blery C, Zatan M. Effect of epidural morphine on postoperative pulmonary dysfunction. Acta Anaesthesiol Scand . 1984; 28 147-151
- 25 Shulman M, Sandler A, Bradley J. Postthoracotomy pain and pulmonary function following epidural and systemic morphine. Anesthesiology . 1984; 61 569-575
- 26 Benhamou D, Samii K, Noviant Y. Effect of analgesia on respiratory muscle function after upper abdominal surgery. Acta Anaesthesiol Scand . 1983; 27 22-25
- 27 Cicala R, Voeller G, Fox T. Epidural analgesia in thoracic trauma: effects of lumbar morphine and thoracic bupivacaine on pulmonary function. Crit Care Med . 1990; 18 229-231
- 28 Buck M, Blumer J. Opioids and other analgesics. Crit Care Clin . 1991; 7 615-637
- 29 Barr J, Donner A. Optimal intravenous dosing strategies for sedatives and analgesics in the intensive care unit. Crit Care Clin . 1995; 11 827-847
- 30 Catley D M, Thornton C, Jordon C. Pronounced, episodic oxygen desaturation in the postoperative period: its association with ventilatory pattern and analgesic regimen. Anesthesiology . 1985; 63 20-28
- 31 Gislason T, Almqvist M, Boman G. Increased CSF opioid activity in sleep apnea syndrome. Chest . 1989; 96 250
- 32 Reeder M K, Muir A D, Foex P. Postoperative myocardial ischaemia: temporal association with nocturnal hypoxaemia. Br J Anaesth . 1991; 67 626-631
- 33 Shapiro B,Warren J, Egol A. Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit: an executive summary. Crit Care Med . 1995; 23 1596-1600
- 34 Brill J. Control of pain. Crit Care Clin . 1992; 8 203-218
- 35 Anand K, Arnold J. Opioid tolerance and dependence in infants and children. Crit Care Med . 1994; 22 334-342
- 36 Lee A, Cooper M, Crain J. The effects of nonsteroidal antiinflammatory drugs on postoperative renal function: a metaanalysis. Anaesth Intensive Care . 1999; 27 574-580
- 37 Kroll W, List W. Pain treatment in the ICU: intravenous, regional or both?. Eur J Anaesthesiol . 1997; 14 49-52
- 38 Myles P, Buckland M, Cannon G. Comparison of patient-controlled analgesia and nurse-controlled infusion analgesia after cardiac surgery. Anaesth Intensive Care . 1994; 22 672-678
- 39 Searle N, Roy M, Bergeron G. Hydromorphone patient-controlled analgesia after coronary artery bypass surgery. Can J Anaesth . 1994; 41 198-205
- 40 Kane R E. Neurologic deficits following epidural or spinal anesthesia. Anesth Analg . 1981; 60 150