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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...

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Related Experiment Video

Updated: Jun 24, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
06:04

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Published on: July 4, 2018

Pain management principles in the critically ill.

Brian L Erstad1, Kathleen Puntillo2, Hugh C Gilbert3

  • 1Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ.

Chest
|April 8, 2009
PubMed
Summary
This summary is machine-generated.

Opioids are standard for intensive care unit (ICU) pain control, but optimal use requires considering patient factors and drug properties. Nonpharmacologic therapies are safe but lack strong evidence for widespread ICU use.

Related Experiment Videos

Last Updated: Jun 24, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
06:04

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Published on: July 4, 2018

Area of Science:

  • Critical Care Medicine
  • Pain Management
  • Pharmacology

Background:

  • Opioids remain the primary method for managing pain in intensive care unit (ICU) patients.
  • Individualizing opioid selection and dosage is crucial, considering pharmacokinetics, drug interactions, and tolerance.
  • Alternative and adjunct pharmacologic therapies present unique challenges in critically ill patients, often lacking extensive study in the ICU setting.

Purpose of the Study:

  • To review conventional pharmacologic and nonpharmacologic pain management strategies for ICU patients.
  • To highlight considerations for opioid selection and alternative pharmacologic agents in critical care.
  • To evaluate the evidence supporting nonpharmacologic pain interventions in the ICU.

Main Methods:

  • Literature review of pharmacologic and nonpharmacologic pain management in ICUs.
  • Analysis of factors influencing opioid efficacy and safety in critically ill patients.
  • Assessment of the evidence base for alternative medications and complementary therapies.

Main Results:

  • Opioid pharmacokinetics in the ICU do not always correlate with clinical benefits.
  • Many alternative pharmacologic agents have limited data and potential administration route issues in ICUs.
  • Nonpharmacologic therapies are accessible and safe but have a limited evidence base for effectiveness in ICUs.

Conclusions:

  • Optimizing opioid therapy requires careful consideration of patient-specific factors and drug characteristics.
  • Further research is needed to establish the efficacy and safety of alternative pharmacologic agents in critical care.
  • Current evidence does not support broad implementation of nonpharmacologic pain management strategies in ICUs due to limited research.