title: Pain and Agitation Management in Critically Ill Patients.
abstract: Pain and agitation may be difficult to assess in a critically ill patient. Pain is best assessed by self-reporting pain scales; but in patients who are unable to communicate, behavioral pain scales seem to have benefit. Patients' sedation level should be assessed each shift and preferably by a validated ICU tool, such as the RASS or SAS scale. Pain is most appropriately treated with the use of opiates, and careful consideration should be given to the pharmacokinetic and pharmacodynamic properties of various analgesics to determine the optimal agent for each individual patient. Sedation levels should preferably remain light or with the use of a daily awakening trial. Preferred treatment of agitation is analgosedation with the addition of nonbenzodiazepine sedatives if necessary. There are risks associated with each agent used in the treatment of pain and agitation, and it is important to monitor patients for effectiveness, signs of toxicity, and adverse drug reactions.
authors.affiliation: Department of Pharmacy Practice, Lipscomb University College of Pharmacy, One University Park Drive, Nashville, TN 37204, USA. Electronic address: Julie.wilbeck@Lipscomb.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Stephens
authors.affiliation: Department of Pharmacy, Williamson Medical Center, 4321 Carothers Parkway, Franklin, TN 37067, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Wright
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003422:Critical Care / Q000592:standards*; D016638:Critical Illness / Q000628:therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011595:Psychomotor Agitation / Q000188:drug therapy*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives
keywords: Agitation; Analgosedation; Opioid; Pain; Pharmacotherapy; Sedation