Management of pain and sedation in the intensive care unit.

Publication date: Dec 09, 2024

Advances in our approach to treating pain and sedation when caring for patients in the intensive care unit (ICU) have been propelled by decades of robust trial data, knowledge gained from patient experiences, and our evolving understanding of how pain and sedation strategies affect patient survival and long term outcomes. These data contribute to current practice guidelines prioritizing analgesia-first sedation strategies (analgosedation) that target light sedation when possible, use of short acting sedatives, and avoidance of benzodiazepines. Together, these strategies allow the patient to be more awake and able to participate in early mobilization and family interactions. The covid-19 pandemic introduced unique challenges in the ICU that affected delivery of best practices and patient outcomes. Compliance with best practices has not returned to pre-covid levels. After emerging from the pandemic and refocusing our attention on optimal pain and sedation management in the ICU, it is imperative to revisit the data that contributed to our current recommendations, review the importance of best practices on patient outcomes, and consider new strategies when advancing patient care.

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Concepts Keywords
Analgesia Conscious Sedation
Awake COVID-19
Benzodiazepines Critical Care
Decades Humans
Refocusing Hypnotics and Sedatives
Hypnotics and Sedatives
Intensive Care Units
Pain Management
SARS-CoV-2

Semantics

Type Source Name
disease MESH covid-19 pandemic
disease MESH Allergy
disease MESH critical illness
disease MESH chronic pain
drug DRUGBANK Oxygen
pathway REACTOME Release
disease MESH delirium
disease MESH respiratory failure
drug DRUGBANK Ethanol
disease MESH syndrome
drug DRUGBANK Aspartame
drug DRUGBANK Fentanyl
drug DRUGBANK Hydromorphone
drug DRUGBANK Morphine
drug DRUGBANK Histamine
drug DRUGBANK Remifentanil
pathway REACTOME Metabolism
drug DRUGBANK Glycine
drug DRUGBANK Hydrocodone
drug DRUGBANK Methadone
drug DRUGBANK Gabapentin
disease MESH neuropathic pain
drug DRUGBANK Pregabalin
disease MESH Somnolence
drug DRUGBANK Ketorolac
disease MESH inflammation
disease MESH bleeding
disease MESH peptic ulcer
drug DRUGBANK Ibuprofen
drug DRUGBANK Acetaminophen
disease MESH hepatic cirrhosis
disease MESH acute hepatic failure
drug DRUGBANK Ketamine
disease MESH hallucinations
drug DRUGBANK Lidocaine
drug DRUGBANK Nefopam
disease MESH tachycardia
disease MESH seizures
drug DRUGBANK Meperidine
drug DRUGBANK Codeine
disease MESH contraindications
disease MESH adverse drug reactions
disease MESH renal insufficiency
disease MESH myoclonus
disease MESH depression
disease MESH hypotension
disease MESH ileus
drug DRUGBANK Buprenorphine
disease MESH insomnia
disease IDO symptom
disease MESH anxiety
disease MESH dyspnea
drug DRUGBANK Gold
disease MESH weaning
disease MESH nosocomial infections
drug DRUGBANK Spinosad
disease MESH coma
drug DRUGBANK Propofol
drug DRUGBANK Lorazepam
drug DRUGBANK Midazolam
drug DRUGBANK Dexmedetomidine

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