Pain management in critically ill patients

2012 ◽  
Vol 3 (8) ◽  
pp. 494-501 ◽  
Author(s):  
Claire Bloor
2021 ◽  
Vol 1 (2) ◽  
pp. 32-34
Author(s):  
Rani Iswara

Pain is a traumatic experience and discomfort for all patients, especially critically ill patients; if not treated properly, it can have harmful effects. Critical illnesses are usually painful, both because of the underlying source of the disease and the necessary procedures performed to monitor and care for these patients. Pain induces anxiety, sleep deprivation, disorientation, agitation, delirium, and often become chronic depression. Psychological factors (sleep deprivation, anxiety, and delirium) can also increase the perception of pain. Pain assessment is required for proper pain management. Opioids are commonly used in pain management, but acetaminophen, dexmedetomidine, and gabapentin have more advantages. The recent trend is multimodal analgesia, which uses a combination of analgesic drugs with different mechanisms of action. Another trend is the increasing use of pain relievers, which can control pain and relieve anxiety.


2019 ◽  
Vol 49 ◽  
pp. 136-142 ◽  
Author(s):  
Marie-José Roos-Blom ◽  
Wouter T. Gude ◽  
Jan Jaap Spijkstra ◽  
Evert de Jonge ◽  
Dave Dongelmans ◽  
...  

Author(s):  
Safoura Beik Rassouli ◽  
Mohammad Reza Rouini ◽  
Farhad Najmeddin ◽  
Azin Gheimati ◽  
Ali A Golabchifar ◽  
...  

Background: Methadone is used for the pain management worldwide. Its special characteristics make it a potential alternative for pain management in critically ill and geriatric patients. Due to lack of studies in this population, we aimed to compare the pharmacokinetic behavior of Methadone following intramuscular and intravenous administration in geriatric ICU patients and with previously reports in healthy volunteers. Methods: According to the limitations in ICU setting, we could include 11 patients over 65 years old, who required opioid for pain relief in this study. Patients were randomized to receive 5 mg of Methadone IM or IV injection every 8 hours for 6 days. The Methadone plasma level detected with LC-mass tandem mass spectrometry, and pharmacokinetics parameters were evaluated for each subject in both 1st and 6th days of treatment. Results: Based on our results, bioavailability of intramuscular Methadone in geriatric ICU patients was low and less than 40% of the dose was absorbed within first 12 hours. The volume of distribution of Methadone in the first day was significantly lower than the previously reported values in healthy subjects and significantly increased during these 6 days. The Methadone half-life in this population also significantly increased through this period. Conclusion: Pharmacokinetic behavior of Methadone in geriatric ICU patients is unpredictable. Reduced volume of distribution and half-life may be observed initially, following with an increase to the normal range. It seems that IM administration of Methadone in geriatric critically ill patients may not provide target analgesic Methadone serum levels.


Injury ◽  
2018 ◽  
Vol 49 (9) ◽  
pp. 1693-1698 ◽  
Author(s):  
Eliza E. Moskowitz ◽  
Lucin Garabedian ◽  
Kimberly Hardin ◽  
Emily Perkins-Pride ◽  
Menilik Asfaw ◽  
...  

2020 ◽  
Vol 46 (9) ◽  
pp. 1671-1682
Author(s):  
Andres Laserna ◽  
Alejandro Durán-Crane ◽  
María A. López-Olivo ◽  
John A. Cuenca ◽  
Cosmo Fowler ◽  
...  

2016 ◽  
Vol 6 (6) ◽  
pp. 591-602 ◽  
Author(s):  
Matthew Kohler ◽  
Felicia Chiu ◽  
Katherine M Gelber ◽  
Christopher AJ Webb ◽  
Paul D Weyker

1991 ◽  
Vol 2 (4) ◽  
pp. 741-747
Author(s):  
Julie A. Stanik

Patient-controlled analgesia (PCA), a system by which patients self-administer intravenous doses of narcotics using specially programmed infusion pumps, has been used for pain management in acute care settings for nearly two decades. The safety and effectiveness of PCA has been documented in many acutely ill patient populations. Its introduction into critical care practice in the last five years has provided an important adjuct to traditional methods of pain management. However, intravenous narcotics of any type can provoke hemodynamic or respiratory complications in these compromised patients. Nursing expertise is a key factor in the successful implementation of PCA in critically ill patients


2021 ◽  
Vol 36 (4) ◽  
pp. 428-430
Author(s):  
Kristen D. Barby ◽  
Nicole Keating ◽  
Mary Beth Flynn Makic

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