03_04_02 Analgesia

Analgesia
Session Overview
Description
This session describes how pain in the intensive care unit (ICU) is multi-factorial and difficult to assess. It shows how potentially useful drugs may also have adverse effects and how non-pharmacological treatment effects must be maximized. The session also reviews effects of pain and describes how analgesia use must be balanced.

Learning Objectives
By the end of this session you will be able to:

• Identify the multifactorial features that cause pain and make pain difficult to assess in patients requiring ICU care
• Recognize and use the non-pharmacological treatments of pain that are appropriate in the ICU setting
• Explain how the pharmacokinetics of analgesic agents may be altered in ICU patients
• Explain how analgesic drugs may interact with other agents in the ICU
• List the positive and negative features of analgesia provision in the ICU

Prerequisites
Before commencing this session you should complete:

• Step I: Paracetamol - Drug and Mechanisms (001-0508)
• Step I: NSAIDS Drugs and Mechanisms, Side Effects and Contraindications (001-0509)
• Step II-III: Opioids - Commonly Available Opioids (001-0512)
• Peripheral - Upper & Lower Limb (001-0499)
• Central - Spinal, Epidurals (001-0500)

It is important to understand the risks and the benefits of both analgesia and pain. The effects of depriving patients of effective analgesia can be seen in Fig 1.

Risks and benefits need to be balanced effectively in order to minimize the overall risk of using analgesia for patients in the intensive care unit (ICU).