Pain Management in the Intensive Care Unit: Do We Need Special Protocols?

Hajiesmaeili, Mohammadreza; Safari, Saeid

doi:10.5812/aapm.4523

Cited by 18 publications

(14 citation statements)

References 14 publications

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“…However, most patients undergoing CABG, experience different levels of pain, usually caused by many sources including sternotomy or leg incisions, tissue retraction and dissection during surgery and chest tube insertion after the surgery ( 8 - 11 ). Besides, the nature of CABG surgery requires admission and hospitalization of patients in Intensive Care Unit (ICU), which due to inability of patients in this ward to report pain due to mechanical ventilation, concomitant use of sedatives, or as a consequence of loss of consciousness, pain control may be precluded frequently ( 12 , 13 ). Postoperative pain in these patients affects not only patients’ operative outcomes, well-being and satisfaction from medical care, but also development of tachycardia, hyperventilation, hypoxemia, insomnia, agitation, myocardial ischemia and delirium, which lead to poor wound healing and increased mortality and morbidity rates, which in turn may impact the operative outcomes ( 8 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

“…Besides, the nature of CABG surgery requires admission and hospitalization of patients in Intensive Care Unit (ICU), which due to inability of patients in this ward to report pain due to mechanical ventilation, concomitant use of sedatives, or as a consequence of loss of consciousness, pain control may be precluded frequently ( 12 , 13 ). Postoperative pain in these patients affects not only patients’ operative outcomes, well-being and satisfaction from medical care, but also development of tachycardia, hyperventilation, hypoxemia, insomnia, agitation, myocardial ischemia and delirium, which lead to poor wound healing and increased mortality and morbidity rates, which in turn may impact the operative outcomes ( 8 , 13 , 14 ). Therefore, pain control is one of the necessary and essential nursing cares in patients undergoing CABG surgery.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Reciting the Word “Allah” on Pain Severity After Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial Study in Iran

et al. 2014

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Background:One of the most expressed complains following coronary artery bypass graft (CABG) surgery is chest wall pain. Due to side effects of opioids used commonly for pain relief after heart surgeries, it is important to use low-cost and non-pharmacological methods independently or combined with palliatives to alleviate pain and consequently prevent undesirable drug adverse eﬀects.Objectives:This study aimed to investigate the effect of Hazrate Zahra’s praises, which is one of the most known praises among Muslims in which the word “Allah” is repeated 100 times, on pain severity after CABG surgery.Patients and Methods:This randomized clinical trial study was performed on 80 patients in Busheher Bentolhoda Hospital, Iran, in 2013. Data was collected by a researcher-made questionnaire and Visual Analogue Scale (VAS). Patients were randomly assigned into intervention (n = 40) and control (n = 40) groups. In intervention group, we asked patients to recite Hazrate Zahra’s praises (AS) as one of the most known praises among Muslims in which the word “Allah” is repeated 100 times. In the control group, patients received routine procedures of hospital. Pain was assessed before and immediately after the intervention in three days after the operation in the both groups. Data was analyzed by SPSS 19 software using descriptive and analytic (Chi-square and independent and paired sample t test) statistical methods.Results:There was a significant difference regarding pain severity after the intervention between the two groups during three days after the operation (respectively P ≤ 0.001, P ≤ 0.001 and P ≤ 0.003), but no significant difference was found between the two studied groups before the intervention. Moreover, a significant difference was seen before and after recitation in the intervention group during three days after the operation (for three days P ≤ 0.001), while in control group no significant difference was revealed before and after the intervention (respectively P = 0.493, P = 0.541 and P = 0.119).Conclusions:Reciting the word “Allah” as a non-pharmacological, low-cost and non-invasive method with no side effects can be effective on pain relief after CABG surgery.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Reciting the Word “Allah” on Pain Severity After Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial Study in Iran

et al. 2014

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“…Pain assessment in ICU patients turns out to be a daily challenge for the attending teams, particularly in those patients who are intubatedendotracheal, on mechanical ventilation or analgosedated. Adding to those challenges are other co-existing mental and neurological disorders such aspsychoses, dementia, aphasia,critical condition-related delirium [2] .…”

Section: Introductionmentioning

confidence: 99%

Management of Pain in the Intensive Care Unit

Alhawaj

Alghazal

Alonazi

et al. 2017

Egyptian Journal of Hospital Medicine

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Background: Pain assessment in ICU patients turns out to be a daily challenge for the attending teams, particularly in those patients who are intubated endotracheally; on mechanical ventilation or analgosedated as such patients are unable to self-assess existence and intensity of pain. Guidelines to identify pain in these patients are crucial for physicians for effective management. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1994, through March 2017. The following search terms were used: pain management in ICU, pain in ICU, pain assessment by behavior, pain assessment in intubated patients. Aim: Our aim in this study was to understand how to assess and manage pain in an intensive care unit patient, particularly those patients who are unable to self-report or assess. Conclusion: Physical clues given by comatose or intubated patients in critical care unit must be used as a method to identify existence of pain, and must be managed effectively to decrease discomfort and prevent short and long term adverse effects.

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“…Acute pain has emerged as a leading stressor for ICU (Intensive Care Unit) patients, moderate to severe pain intensity which has been observed in nearly 50% of ICU patients. While pain is widely recognized as the so-called fifth vital sign and we believed pain relief is an essential human right ( 1 , 2 ). Researchers demonstrated that 95% of physicians and 81% of nurses felt that the patient had adequate analgesia, whereas 74% of patients rated their pain as moderate or severe, in traumatic critically ill patients admitted to an ICU ( 3 ).…”

mentioning

confidence: 99%

“…In traumatic and surgically critical ill patients, the pain associated with ventilatory function impairment and increases pulmonary morbidity such as nosocomial pneumonia, atelectasis and etc. ( 1 ) and in surgical ICU patients, early mobilization and rehabilitation with minimally associated pain and discomfort is the most desirable feature, reducing thromboembolic events an improved surgical outcome ( 4 ). Multiple modalities are available to the clinician for the treatment of pain in critically ill patients.…”

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confidence: 99%