title: Evaluation and treatment of pain in critically ill adults.
abstract: Pain is experienced by the overwhelming majority of patients during their intensive care unit stay, but it remains an underappreciated problem. To effectively treat pain, it must be detected and quantified using a validated assessment tool. It is acknowledged that optimal pain relief may be difficult to achieve given the complex interplay of coexisting medical conditions and the environment in which care is provided. Nonetheless, by following structured approaches to pain, resource consumption may be reduced, and even improved survival may be realized. This review covers practices and techniques specific to addressing and treating pain in the adult intensive care environment. Traditional pharmacological approaches including opiate and nonopiate medications are reviewed, as are regional anesthetic techniques and nonpharmacological approaches used for controlling pain.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington/Harborview Medical Center, Seattle, Washington 98104, USA. joffea@uw.edu
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Joffe
authors.forename: Matt
authors.initials: M
authors.lastname: Hallman
authors.forename: Céline
authors.initials: C
authors.lastname: Gélinas
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Herr
authors.forename: Kathleen
authors.initials: K
authors.lastname: Puntillo
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000765:Anesthesia, Conduction / Q000379:methods; D000818:Animals; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid