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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...
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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...
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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...
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Angina V: Nursing Management01:20

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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...
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Parenteral Anesthetics: Overview01:24

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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.
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Peripheral Artery Disease IV: Nursing Management01:26

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 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,...
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Updated: Oct 2, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Pain in Intensive Care: A Narrative Review.

Vincenzo Pota1, Francesco Coppolino2, Alfonso Barbarisi3

  • 1Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", Naples, Italy. vincenzo.pota@unicampania.it.

Pain and Therapy
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PubMed
Summary
This summary is machine-generated.

Critically ill patients in intensive care units (ICUs) often experience pain, which can lead to chronic pain. Multimodal approaches, combining opioids with adjuvant medications, are key to improving pain management and patient experience in the ICU.

Keywords:
Acute painAssessmentDeliriumIntensive careProcedural pain

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Area of Science:

  • Critical Care Medicine
  • Pain Management
  • Anesthesiology

Background:

  • Critically ill adult patients in intensive care units (ICUs) frequently experience pain, with varying intensity influenced by individual factors, procedures, and diseases.
  • Inadequate acute pain management increases the risk of chronic pain in up to 33% of ICU survivors.
  • Effective pain management is crucial, yet patients in ICUs often cannot communicate their pain state.

Purpose of the Study:

  • To review current strategies for pain management in critically ill adult patients.
  • To highlight the challenges in assessing and managing pain in non-communicative ICU patients.
  • To emphasize the benefits of multimodal analgesia in improving patient outcomes and reducing adverse effects.

Main Methods:

  • Review of existing clinical practice guidelines for pain, agitation, and delirium management in ICUs.
  • Analysis of observational research on analgesic treatments, particularly opioid use in mechanically ventilated patients.
  • Discussion of the role of adjuvant medications in conjunction with opioids for enhanced analgesia.

Main Results:

  • Opioids are the primary analgesic choice for non-neuropathic pain in critically ill patients, used in over 80% of mechanically ventilated cases.
  • Opioid consumption and painful experiences in the ICU are linked to post-traumatic stress disorder (PTSD) post-discharge.
  • Adjuvant medications can be associated with opioids to reduce side effects and maintain effective analgesia.

Conclusions:

  • Multimodal approaches offer an opportunity to improve the patient experience in the ICU by optimizing pain management.
  • Addressing pain effectively is critical to prevent the transition from acute to chronic pain and reduce long-term psychological distress like PTSD.
  • Integrating adjuvant therapies with opioid analgesia is a recommended strategy for comprehensive pain control in the ICU.