Management of pain in the intensive care patient

Abstract

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Critically ill patients commonly experience moderate to severe, acute pain that, if underestimated, may increase the risk of persistent or chronic pain and increase hospital stay. This problem is compounded by the difficulty that critically ill patients have in communicating their pain to staff on the intensive care unit. Accurate assessment of pain is therefore central to the care of the critically ill patient. Pain should be objectively and continuously assessed using a validated assessment tool. Guidelines recommend use of the Numeric Rating Scale, which has been shown to improve pain control and reduce the need for sedation. Non-pharmacological measures are an essential first step, but targeted analgesia remains the cornerstone of care. This approach is based on an individual plan for pain control for each patient, which is communicated to all caregivers to ensure consistency of therapy. © The Intensive Care Society 2010.