title: [Analgesia in intensive care medicine].
abstract: BACKGROUND
  The administration of sedatives and analgesics on the intensive care unit (ICU) is routine daily practice. The correct discrimination between delirium, pain and anxiety or confusion is essential for the strategy and selection of medication. The correct pain therapy and sedation are essential for patient quality of life on the ICU and for the prognosis.
  
  
  OBJECTIVE
  The aim of this article is to present state of the art recommendations on the classification of pain and pain therapy on the ICU.
  
  
  METHODS
  An online search was carried out in PubMed for publications on the topics of "pain" and "ICU".
  
  
  RESULTS
  Critical care patients are frequently subjected to many procedures and situations which can cause pain. The perception of pain is, among other things, influenced by the degree of orientation, anxiety and the degree of sedation. The administration of analgesics and non-pharmacological approaches are effective in reducing the stress perceived by patients.
  
  
  CONCLUSIONS
  The main aim is improvement in the awareness of nursing and medical personnel for pain inducers and pain perception in ICU patients. The classification of pain must be made objectively. Therapeutic targets must be defined and in addition to the correct selection of pain medication, non-pharmacological approaches must also be consistently implemented.
authors.affiliation: Klinik für Innere Medizin und Intensivmedizin, Asklepios Kliniken Schildautal, Karl-Herold-Str. 1, 38723, Seesen, Deutschland. j.ortlepp@asklepios.com.
authors.forename: J R
authors.initials: JR
authors.lastname: Ortlepp
authors.affiliation: Internistische Intensivstation, Klinik für Innere Medizin und Intensivmedizin, Asklepios Kliniken Schildautal, Seesen, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Luethje
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Walz
mesh_terms: D000698:Analgesia / Q000379:methods*; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy; D003422:Critical Care / Q000379:methods*; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods
keywords: Analgesics; Anxiety; Delirium; Pain measurement; Pain treatment, non-pharmcological
references.citation: Am J Respir Crit Care Med. 2012 Oct 15;186(8):724-31
references.pmid: 22859526
references.citation: Eur J Clin Pharmacol. 2010 Jul;66(7):713-9
references.pmid: 20300741
references.citation: Crit Care Med. 2013 Jan;41(1):263-306
references.pmid: 23269131
references.citation: Crit Care. 2014 Jun 18;18(3):R125
references.pmid: 24942154
references.citation: J Cardiovasc Thorac Res. 2015;7(2):43-8
references.pmid: 26191390
references.citation: Cochrane Database Syst Rev. 2014 Jul 09;(7):CD009176
references.pmid: 25005604
references.citation: Crit Care Clin. 2004 Jul;20(3):381-401, viii
references.pmid: 15183209
references.citation: JAMA. 2004 Apr 14;291(14):1753-62
references.pmid: 15082703
references.citation: Intensive Care Med. 2014 Jan;40(1):1-10
references.pmid: 24132382
references.citation: Intensive Care Med. 2013 Dec;39(12):2180-7
references.pmid: 24013436
references.citation: J Adv Nurs. 2009 Jan;65(1):203-16
references.pmid: 19032510
references.citation: Pain. 2010 Dec;151(3):711-21
references.pmid: 20843604
references.citation: Heart Lung. 2003 Jul-Aug;32(4):275-82
references.pmid: 12891169
references.citation: Pain Res Manag. 2015 Jan-Feb;20(1):e33-7
references.pmid: 25050877
references.citation: Eur J Anaesthesiol. 2009 Aug;26(8):648-53
references.pmid: 19487950
references.citation: Crit Care Med. 2001 Dec;29(12):2258-63
references.pmid: 11801819
references.citation: J Crit Care. 2010 Sep;25(3):458-62
references.pmid: 20189753
references.citation: Am J Respir Crit Care Med. 2014 Jun 1;189(11):1383-94
references.pmid: 24720509
references.citation: J Crit Care. 2015 Oct;30(5):1043-8
references.pmid: 26116140
references.citation: Ann Card Anaesth. 2007 Jan;10(1):42-5
references.pmid: 17455407
references.citation: Crit Care Med. 2004 Feb;32(2):421-7
references.pmid: 14758158
references.citation: J Cardiothorac Vasc Anesth. 2015 Aug;29(4):990-4
references.pmid: 25939965
references.citation: Lancet. 1999 Jun 12;353(9169):2051-8
references.pmid: 10376632
references.citation: J Crit Care. 2014 Oct;29(5):803-7
references.pmid: 24866021
references.citation: Crit Care. 2014 Jul 21;18(4):R156
references.pmid: 25047960
references.citation: PLoS One. 2015 Jan 23;10(1):e0115332
references.pmid: 25616059
references.citation: Crit Care Med. 2002 Nov;30(11):2468-72
references.pmid: 12441756
references.citation: AACN Clin Issues. 2000 Feb;11(1):77-96
references.pmid: 11040555
references.citation: Crit Care. 2007;11(6):R124
references.pmid: 18062820
references.citation: JAMA. 2013 Jun 12;309(22):2335-44
references.pmid: 23689789
references.citation: Am J Crit Care. 2006 Jul;15(4):420-7
references.pmid: 16823021