Pain in the ICU

Azzam, Pierre N.; Alam, Abdulkader

doi:10.1177/0885066611432417

Cited by 20 publications

(5 citation statements)

References 101 publications

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“…This could create anxiety which has been shown to correlate with pain (Azzam & Alam, 2012). To assess and treat pain is also mentioned as one of the first action to prevent ICU delirium (Marra, Frimpong, & Ely, 2016).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Patients´ experiences of pain in the intensive care – The delicate balance of control

Hylén

Åkerman

Idvall

et al. 2020

Journal of Advanced Nursing

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Aim To explore the patients´ experiences of pain when being cared for in the intensive care. Design An exploratory, qualitative design was chosen. Method Interviews were performed with patients (October 2015–March 2017) within a week of post‐intensive care (N = 16). Thematic analysis was used as method for analysis. Results The findings generated two themes – a lack of control and to struggle for control. Pain was described as overwhelming, both in body and mind and generating the experience of a lack of control, with feelings of incapacitation, isolation, and having their needs unmet. Feeling in control of the pain and thus in control of the situation was experienced as a constant struggle. Well‐planned care, finding ways to handle the pain and good communication were all helpful in this struggle. Conclusion The participants recalled their experience of pain in the ICU and control seems to be crucial for how pain is experienced. They experienced a lack of control due to not only the pain but also the treatment, which can be avoided by the nurse continuously evaluating and individualising the care. Balanced care, meeting the patients’ needs and good communication helps the patient feel more in control when experiencing pain. Impact The experience of pain is dependent on control for the intensive care patient. The nurse may help them gain control and thereby handle the experience of pain through including the patient, striving for better communication and implementing individualised care that continuously assesses and treats pain.

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Section: Backg Rou N Dmentioning

confidence: 99%

Patients´ experiences of pain in the intensive care – The delicate balance of control

Hylén

Åkerman

Idvall

et al. 2020

Journal of Advanced Nursing

View full text Add to dashboard Cite

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“…Where oral administration of medications is not possible, pre-admission oral medications should be changed to intravenous forms (Peng et al, 2005; Alford et al, 2006; Mehta and Langford, 2006). Prior to ICU discharge, there should be carefull tapering of opioids where appropriate to ensure long term opioids are not continued unnecessarily leading to chronic opioid use (Azzam and Alam, 2013). The aim should be to return patients to at most the doses they were taking prior to critical care admission.…”

Section: Methodsmentioning

confidence: 99%

Chronic Pain and Chronic Opioid Use After Intensive Care Discharge – Is It Time to Change Practice?

et al. 2019

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Almost half of patients treated on intensive care unit (ICU) experience moderate to severe pain. Managing pain in the critically ill patient is challenging, as their pain is complex with multiple causes. Pharmacological treatment often focuses on opioids, and over a prolonged admission this can represent high cumulative doses which risk opioid dependence at discharge. Despite analgesia the incidence of chronic pain after treatment on ICU is high ranging from 33–73%. Measures need to be taken to prevent the transition from acute to chronic pain, whilst avoiding opioid overuse. This narrative review discusses preventive measures for the development of chronic pain in ICU patients. It considers a number of strategies that can be employed including non-opioid analgesics, regional analgesia, and non-pharmacological methods. We reason that individualized pain management plans should become the cornerstone for critically ill patients to facilitate physical and psychological well being after discharge from critical care and hospital.

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“…Among the pharmacological approaches to pain control, opioids constitute the mainstay of treatment in the ICU [19,20], yet pain has been shown to persist even during unrestricted use of these analgesic agents [13,21]. The use of complementary nonpharmacologic interventions such as massage has been suggested in the clinical practice guidelines of the Society of Critical Care Medicine given their opioid-sparing and analgesia-enhancing potential [20].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Hand Massage on Pain in Critically Ill Patients After Cardiac Surgery: A Randomized Controlled Trial Protocol

et al. 2016

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BackgroundPostoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown.ObjectiveThe objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery.MethodsA 3-arm randomized controlled trial will be conducted. A total of 79 patients who are 18 years or older, able to speak French or English and self-report symptoms, have undergone elective cardiac surgery, and do not have a high risk of postoperative complications and contraindications to hand massage will be recruited. They will be randomly allocated (1:1:1) to standard care plus either 3 20-minute hand massages (experimental), 3 20-minute hand holdings (active control), or 3 20-minute rest periods (passive control). Pain intensity, unpleasantness, anxiety, muscle tension, and vital signs will be evaluated before, immediately after, and 30 minutes later for each intervention administered within 24 hours postoperatively. Peer-reviewed competitive funding was received from the Quebec Nursing Intervention Research Network and McGill University in December 2015, and research ethics approval was obtained February 2016.ResultsRecruitment started in April 2016, and data collection is expected to be complete by January 2017. To date, 24 patients were randomized and had data collection done.ConclusionsThis study will be one of the first randomized controlled trials to examine the effect of hand massage on the pain levels of critically ill patients after cardiac surgery and to provide empirical evidence for the use of massage among this population.ClinicalTrialClinicalTrials.gov NCT02679534; https://clinicaltrials.gov/ct2/show/NCT02679534 (Archived by WebCite at http://www.webcitation.org/6l8Ly5eHS)

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Pain in the ICU

Cited by 20 publications

References 101 publications

Patients´ experiences of pain in the intensive care – The delicate balance of control

Patients´ experiences of pain in the intensive care – The delicate balance of control

Chronic Pain and Chronic Opioid Use After Intensive Care Discharge – Is It Time to Change Practice?

The Effectiveness of Hand Massage on Pain in Critically Ill Patients After Cardiac Surgery: A Randomized Controlled Trial Protocol

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