MANAGEMENT OF PAIN IN ICU
Walaa Khalil Ahmed;
Abstract
In this study the pain is defined as an unpleasant feeling and emotional experience that is related to real or potential tissue damage. And we explaine the pain pathways and the Physiology of nociception. Then mention the causes of pain in ICUs as:
A- Causes related to primary pathology.
B- Complications of the original condition or new problems.
C- Other causes.
Pain can be clinically classified into: acute and chronic pain, and can also be classified according to:
• Pathophysiology (e.g. nociceptive or neuropathic pain).
• Etiology (e.g. postoperative or cancer pain).
• Affected area (e.g. headache or low back pain).
Pain assessment in the ICU remains a challenge for clinicians and researchers, Various pain scales are available, but it remains unclear whether they can be applied reliably in the diverse patient population of the ICU.
Pain can come from a variety of diseases, disorders, and injuries, and there are physicians who specialize in treating each of those sources of pain. Finding the right pain management specialist can be crucial.
Then we highlight the different methods of treatment of pain in critically ill patient which include the following:
A- Pharmacological management, which include:
1- Opioid analgesics. such as:
Morphine, fentanyl, hydromorphone, fentanyl derivatives, codeine and tramadol.
2- Non opioid analgesics. Such as:
Ketamine, Acetaminophen, NSAIDs, Gabapentinoids, Carbamazepine, GABA (gamma-aminobutyric acid) agonists, Lorazepam, Propofol, Alpha-2 adrenergic agonists, Etomidate and Neuromuscular blockers.
B- Non Pharmacological management.:
It is considered that these therapies help the standard pharmacological treatment in pain management, These therapies can treat the middle level and severe pain experiences as an adjuvant or complementary treatment.
C- Interventional pain management:
Is a subspecialty of the medical specialty, pain managemnt, devoted to the use of invasive techniques such as facet joint injections ,nerve blocks (interrupting the flow of pain signals along specific nervous system pathways), neuroaugmentation (including spinal cord stimulation and priphral nerve stimulation), and implantable drug delivery systems.
Finally, Pain is a frequently experienced problem in critically ill patients in ICU, and it may increase morbidity and mortality and may decrease the comfort of patients and health, So the proper management may decrease morbidity and mortality.
A- Causes related to primary pathology.
B- Complications of the original condition or new problems.
C- Other causes.
Pain can be clinically classified into: acute and chronic pain, and can also be classified according to:
• Pathophysiology (e.g. nociceptive or neuropathic pain).
• Etiology (e.g. postoperative or cancer pain).
• Affected area (e.g. headache or low back pain).
Pain assessment in the ICU remains a challenge for clinicians and researchers, Various pain scales are available, but it remains unclear whether they can be applied reliably in the diverse patient population of the ICU.
Pain can come from a variety of diseases, disorders, and injuries, and there are physicians who specialize in treating each of those sources of pain. Finding the right pain management specialist can be crucial.
Then we highlight the different methods of treatment of pain in critically ill patient which include the following:
A- Pharmacological management, which include:
1- Opioid analgesics. such as:
Morphine, fentanyl, hydromorphone, fentanyl derivatives, codeine and tramadol.
2- Non opioid analgesics. Such as:
Ketamine, Acetaminophen, NSAIDs, Gabapentinoids, Carbamazepine, GABA (gamma-aminobutyric acid) agonists, Lorazepam, Propofol, Alpha-2 adrenergic agonists, Etomidate and Neuromuscular blockers.
B- Non Pharmacological management.:
It is considered that these therapies help the standard pharmacological treatment in pain management, These therapies can treat the middle level and severe pain experiences as an adjuvant or complementary treatment.
C- Interventional pain management:
Is a subspecialty of the medical specialty, pain managemnt, devoted to the use of invasive techniques such as facet joint injections ,nerve blocks (interrupting the flow of pain signals along specific nervous system pathways), neuroaugmentation (including spinal cord stimulation and priphral nerve stimulation), and implantable drug delivery systems.
Finally, Pain is a frequently experienced problem in critically ill patients in ICU, and it may increase morbidity and mortality and may decrease the comfort of patients and health, So the proper management may decrease morbidity and mortality.
Other data
| Title | MANAGEMENT OF PAIN IN ICU | Other Titles | عـــلاج الألــم فــى وحــدات العنايــة المركــزة | Authors | Walaa Khalil Ahmed | Issue Date | 2015 |
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