REVIEW   Free access

Minerva Anestesiologica 2019 October;85(10):1118-28

DOI: 10.23736/S0375-9393.19.13447-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Regional analgesia techniques for pain management in patients admitted to the intensive care unit

Ruben RUBIO-HARO ¹, Javier MORALES-SARABIA ¹, Carolina FERRER-GOMEZ ¹, José de ANDRES ² ✉

¹ Department of Anesthesia, General University Hospital, Valencia, Spain; ² Department of Anesthesiology, Critical Care and Pain Management, General University Hospital, Valencia University Medical School, Valencia, Spain

Controlling pain should be a priority in the clinical practice of intensive care units (ICUs). Monomodal analgesic approaches, such as the administration of opioids, are widely employed; however, the widespread use of opioids has catastrophic consequences, given their multiple side effects and the development of dependence. Regional analgesia (RA), with single or continuous dosing using neuraxial and peripheral catheters, can play an important role in multimodal analgesia for management of pain in critical care patients. RA provides superior pain control, as compared to systemic treatments, and is associated with a lower rate of side effects. Nevertheless, RA remains underused in ICUs. Many critically ill, post-surgical or traumatically injured patients would benefit from these techniques. For these reasons, we aim to establish a set of potential indications integrating the use of RA in analgesia protocols routinely used in ICUs. We performed a review of literature sources with contrasted evidence levels to present RA techniques and their potential applications in ICU patients.

KEY WORDS: Regional analgesia; Pain management; Critical illness; Intensive care units; Multimodal imaging; Opioid analgesics