Pain Management Considerations in Critical Care

Pain managementPain management is an essential component of critical careCritical care medicine, and effective treatment improves short and long-term patient outcomes. At the forefront is the need for regular assessmentsAssessment of pain using validated tools, a few of which are validated for patients able to communicate, or alternative tools for patients who are unable to effectively communicate. With a recent recognition of harm resulting from heavy sedation and immobility, current trends in critical care have transitioned to the concept of “analgosedationAnalgosedation.” This treatment paradigm prioritizes the use of multimodal analgesiaMultimodal analgesia prior to the administration of sedating medications to facilitate early mobilization and participation with rehabilitation exercises. While the administration of opioidsOpioids remains a common practice in the intensive care unit, multimodal anesthesiaAnesthesia using non-opioid medications, as well as regional anesthetic techniques have demonstrated improved outcomes and, in some cases, a decreased incidence of chronic painChronic pain syndromes. The critically ill population provides several unique challenges to pain management that are discussed in this chapter.