Korean J Med.  2014 May;86(5):546-556.

Management of Pain, Agitation and Delirium in the Intensive Care Units

• Jeon K

Abstract

Pain, agitation and delirium (PAD) occur frequently in mechanically ventilated patients in the intensive care unit (ICU). Consequently, analgesics and sedatives are frequently administered to critically ill patients with the aim of treating PAD, decreasing the physiological stress response, and improving synchrony with mechanical ventilation. However, many of the analgesics and sedatives in current use can lead to adverse outcomes, including longer durations of mechanical ventilation, prolonged ICU stays, delirium, and an increased risk of death, particularly when these agents are administered at excessive doses for prolonged periods. The purpose of this review is to provide an overview of the initial evaluation and monitoring of, and the medications commonly prescribed for, PAD. Moreover, we highlight the major recommendations of the recent guidelines published by the Korean Society of Critical Care Medicine and American College of Critical Care Medicine.

Keyword

Pain; Psychomotor agitation; Delirium; Intensive care units

MeSH Terms

Analgesics
Critical Care
Critical Illness
Delirium*
Dihydroergotamine*
Humans
Hypnotics and Sedatives
Intensive Care Units*
Psychomotor Agitation
Respiration, Artificial
Stress, Physiological
Analgesics
Dihydroergotamine
Hypnotics and Sedatives