Parenteral opioids are the mainstay of effective pain therapy during the early phase of intensive care. There is only a very limited place for non-opioid-analgesics in the intensive care unit (ICU), perhaps with the exception of ketamine and clonidine. Central neuraxial blocks with local anesthetics and/or opioids are highly effective measures for the control of severe pain. However, their use in the ICU is limited because of possible complications (hemorrhage, neurological damage, spinal infection) and contraindications (sepsis, anticoagulants). Specific therapeutic measures such as transcutaneous electric nerve stimulation have shown proven efficacy after cardiothoracic surgery, but have not become routine in most hospitals.
Was this article helpful?