Korean J Crit Care Med.  2014 Aug;29(3):147-159. 10.4266/kjccm.2014.29.3.147.

Assessment and Treatment of Pain in Adult Intensive Care Unit Patients

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea. pjm4013@naver.com

Abstract

In most cases, patients admitted to an intensive care unit (ICU) have suffered from severe trauma, undergone major surgery or been treated for a serious medical illness. Although they often experience more intense pain than general ward patients, they are frequently unable to communicate their experiences to health care providers, thus preventing accurate assessment and treatment of their pain. If appropriate measures are not taken to treat pain in critically ill patients, stress response or sympathetic overstimulation can lead to complications. The short-term consequences of untreated pain include higher energy expenditure and immunomodulation. Longer-term, untreated pain increases the risk of post-traumatic stress disorder. Because pain is quite subjective, the accurate assessment of pain is very difficult in the patients with impaired communication ability. The current most valid and reliable behavioral pain scales used to assess pain in adult ICU patients are the Behavioral Pain Scale and the Critical-Care Pain Observation Tool. Once pain has been accurately assessed using these methods, various pharmacologic and non-pharmacologic therapies should be performed by the multidisciplinary care team. Accurate assessment and proper treatment of pain in adult ICU patients will improve patients outcome, which reduces the stress response and decreases the risk of post-traumatic stress disorder.

Keyword

intensive care units; nerve block; opioid; pain measurement; posttraumatic stress disorders; sympathetic nervous system

MeSH Terms

Adult*
Communication
Critical Illness
Energy Metabolism
Health Personnel
Humans
Immunomodulation
Intensive Care Units*
Nerve Block
Pain Measurement
Patients' Rooms
Stress Disorders, Post-Traumatic
Sympathetic Nervous System
Weights and Measures
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