| Abstract: |
Pain is a prominent part of the patient experience in the ICU. The goal of therapy is to provide adequate analgesia and sedation without using adverse autonomic or cardiopulmonary consequences.A balanced, ultidrug approach is usually the best way to minimize side effects.Providing effective pain relief in the critical care unit is one of the most direct methods of decreasing postoperative complications and healthcare costs in high-risk surgical patients.The pathophysiology of pain consists of nociceptors, afferent fibers, spinal cord, supraspinal pathways of pain, neurochemistry and modulation of pain and deleterious effects of pain.Assessment of pain in the ICU is challenging, a major challenge is facing comatose patients, patients on mechanical ventilation, endotracheal tube or trahceostomy, the second step is identifying the underlying cause.Pain in ICU can be managed by different methods including pharmacological methods as local anesthetics, NSAIDs, opioids, PCA and alpha-2-adrenergic agonists like clonidine, popular regional analgesic techniques whether central neuroaxial blockade like intrathecal opioid epidural opioids or peripheral nerve block like local infiltration, intercostal nerve block, paravertebral block or interpleural-block and physical methods as acupuncture cryoanalgesia, hypnosis, music, organ rest, cold-compresses or hot fomentation.
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