title: Regional analgesia in postsurgical critically ill patients.
abstract: Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed. The critical patient certainly must be analyzed individually as their own primary conditions is of vital importance, as well as any associated conditions they have developed that can potentially increase the risk of systemic toxicity or morbidity, such as, coagulopathies, infection, immunosuppressive states, sedation and problems associated with mechanical ventilation. This review aims to assess the role of regional analgesia in critically ill patients, placing it within the algorithm decision tree of the professional responsible for patients in critical care units, all based on the evidence of potential benefits according to the published literature.
authors.affiliation: Servicio de Anestesia, Reanimación y Unidad Multidisciplinar de Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: S
authors.initials: S
authors.lastname: Moliner Velázquez
authors.affiliation: Facultad de Medicina, Universidad de Valencia, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Rubio Haro
authors.affiliation: Facultad de Medicina, Universidad de Valencia, Valencia, España.
authors.forename: C
authors.initials: C
authors.lastname: De Andrés Serrano
authors.affiliation: Servicio de Anestesia, Reanimación y Unidad Multidisciplinar de Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España; Departamento de Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, España. Electronic address: deandres_jos@gva.es.
authors.forename: J
authors.initials: J
authors.lastname: De Andrés Ibáñez
mesh_terms: D000367:Age Factors; D000698:Analgesia / Q000009:adverse effects / Q000379:methods; D002395:Catecholamines / Q000378:metabolism; D015897:Comorbidity; D016638:Critical Illness / Q000523:psychology; D004734:Energy Metabolism; D005769:Gastrointestinal Motility; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology / Q000628:therapy; D007249:Inflammation / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D010147:Pain Measurement; D058748:Pain Perception; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D012120:Respiration Disorders / Q000209:etiology / Q000503:physiopathology; D012121:Respiration, Artificial; D013312:Stress, Physiological; D013564:Sympathetic Nervous System / Q000503:physiopathology; D019851:Thrombophilia / Q000209:etiology / Q000517:prevention & control
chemical_list: D002395:Catecholamines
keywords: Analgesia; Anestesia Regional; Complicaciones; Complications; Cuidados Intensivos; Dolor; Intensive Care; Pain; Regional Anesthesia