CLINICAL OVERVIEW

Pain Management in the Critically Ill Adult Patient

This clinical overview equips health professionals with a practical, patient-centered approach to pain management in the critically ill adult population. It emphasizes the importance of routine and systematic pain assessment using validated tools like the CPOT and BPS, particularly for patients unable to self-report. The overview explores a multimodal approach to pain management, encompassing both pharmacologic and non-pharmacologic therapies. It provides detailed guidance on opioid selection and dosing, considering pharmacokinetic and pharmacodynamic properties, as well as potential adverse effects. The overview also discusses non-opioid analgesics, adjuvant analgesics, and regional anesthetic techniques. Special considerations for managing pain in patients with kidney disease, liver disease, and opioid tolerance are addressed, including medication selection, dosage adjustments, and the importance of specialist consultation. The article highlights the ABCDEF bundle as a structured, multidisciplinary approach to improve pain management and overall outcomes in critically ill patients, emphasizing the importance of proactive pain prevention and family engagement. Finally, the overview addresses potential complications of pain management, including respiratory depression, hypotension, and delirium, and provides guidance on monitoring and treatment.