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29-07-2022 | Care | Special Issue Insight

Monitoring pain in the intensive care unit (ICU)

Authors: Gerald Chanques, Céline Gélinas

Published in: Intensive Care Medicine | Issue 10/2022

Excerpt

Most patients report pain during their stay in the intensive care unit (ICU). Pain is multifactorial and can be caused by critical illness, invasive treatment, and standard care procedures [1, 2]. Moreover, pain can induce stress responses that may play an important role in critical illness (e.g., tachycardia, polypnea, increased oxygen consumption), as well as long term psychological stress [1]. Therefore, it is paramount that nurses and physicians be able to monitor and detect pain using valid tools, to titrate analgesic doses, minimise their overuse and serious side-effects, as well as to detect medical complications during ICU stay. Monitoring pain is associated with improved patients’ outcomes in ICU (e.g., decrease in sedative use, reduction of mechanical ventilation duration and length of stay) [3, 4] and should be adjusted to the patient’s condition (Fig. 1) [1]. The same tool should be used in a given patient with a given condition to monitor change. …

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Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP, Watson PL, Weinhouse GL, Nunnally ME, Rochwerg B, Balas MC, van den Boogaard M, Bosma KJ, Brummel NE, Chanques G, Denehy L, Drouot X, Fraser GL, Harris JE, Joffe AM, Kho ME, Kress JP, Lanphere JA, McKinley S, Neufeld KJ, Pisani MA, Payen JF, Pun BT, Puntillo KA, Riker RR, Robinson BRH, Shehabi Y, Szumita PM, Winkelman C, Centofanti JE, Price C, Nikayin S, Misak CJ, Flood PD, Kiedrowski K, Alhazzani W (2018) Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 46:e825–e873CrossRef

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Chanques G, Constantin JM, Devlin JW, Ely EW, Fraser GL, Gelinas C, Girard TD, Guerin C, Jabaudon M, Jaber S, Mehta S, Langer T, Murray MJ, Pandharipande P, Patel B, Payen JF, Puntillo K, Rochwerg B, Shehabi Y, Strom T, Olsen HT, Kress JP (2020) Analgesia and sedation in patients with ARDS. Intensive Care Med 46:2342–2356CrossRef

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Ledowski T (2019) Objective monitoring of nociception: a review of current commercial solutions. Br J Anaesth 123:e312–e321CrossRef

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Vinclair M, Schilte C, Roudaud F, Lavolaine J, Francony G, Bouzat P, Bosson JL, Payen JF (2019) Using pupillary pain index to assess nociception in sedated critically ill patients. Anesth Analg 129:1540–1546CrossRef

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Chanques G, Tarri T, Ride A, Prades A, De Jong A, Carr J, Molinari N, Jaber S (2017) Analgesia nociception index for the assessment of pain in critically ill patients: a diagnostic accuracy study. Br J Anaesth 119:812–820CrossRef

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Chanques G, Delay JM, Garnier O, Berra J, Prades A, Carr J, de Jong A, Molinari N, Jaber S (2018) Is there a single non-painful procedure in the intensive care unit? It depends! Intensive Care Med 44:528–530CrossRef

18.

Gelinas C, Shahiri TS, Richard-Lalonde M, Laporta D, Morin JF, Boitor M, Ferland CE, Bourgault P, Richebe P (2021) Exploration of a multi-parameter technology for pain assessment in postoperative patients after cardiac surgery in the intensive care unit: the nociception level index (NOL) (TM). J Pain Res 14:3723–3731CrossRef

19.

Shahiri TS, Richard-Lalonde M, Richebe P, Gelinas C (2020) Exploration of the nociception level (NOL) index for pain assessment during endotracheal suctioning in mechanically ventilated patients in the intensive care unit: an observational and feasibility study. Pain Manag Nurs 21:428–434CrossRef

Title: Monitoring pain in the intensive care unit (ICU)
Authors: Gerald Chanques
Céline Gélinas
Publication date: 29-07-2022
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: Intensive Care Medicine / Issue 10/2022
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-022-06807-w

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Monitoring pain in the intensive care unit (ICU)

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