Regional Analgesia in pain management for ICU patients

Abstract

Most critically ill patients will likely experience pain sometime during their ICU stay and identify it as a great source of stress (Barr et al., 2013)

The stress response evoked by pain can have deleterious consequences for ICU patients. Increased circulating catechol¬amines can cause arteriolar vasoconstriction, impair tissue per¬fusion, and reduce tissue-oxygen partial pressure . Other responses triggered by pain include catabolic hypermetabolism resulting in hyperglycemia, lipolysis, and breakdown of muscle (Barr et al., 2013)

Effective analgesia in critically ill patients improves lung function, ventilatory weaning and early mobilization, and decreases the plasma levels of catecholamines and myocardial oxygen consumption. Regional analgesia is particularly effective in achieving these objectives ( Guedes et al., 2012)

Regional anesthesia and analgesia refers to techniques that use needles, catheters, and infusion devices to deliver medications in close proximity to peripheral nerves, plexuses, nerve roots, ganglia, or directly into spinal fluid. (Clark and Gilbert 2001)

Regional anesthesia is frequently utilized in the operating rooms for patients who are subsequently admitted to an ICU. Regional anesthesia has been associated with superior, sustained analgesia, reduced nausea, vomiting and sedation, and decreased requirement