Review article
https://doi.org/10.20471/acc.2023.62.s4.12
Personalised Pain Treatment in Intensive Care Units - Monitoring of Nociception
Mirjana Lončarić-Katušin
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, OB Karlovac, Karlovac, Croatia
Dorian Ovčar
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, OB Karlovac, Karlovac, Croatia
Antonio Žilić
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, OB Karlovac, Karlovac, Croatia
Jana Kogler
; Clinic for Anesthesiology, Resuscitation and Intensive Care Medicine and Pain Therapy, Clinical Hospital Center Zagreb, Zagreb, Croatia
Ivan Radoš
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Abstract
The personalization of pain treatment in intensive care units was developed due
to the interindividual variability and heterogeneity of critically ill patients. A personalized approach to
pain is based on the prediction and continuous assessment of pain. In critically ill patients, this approach
includes the knowledge of the underlying cause of pain related to the primary diagnosis, the causes of
procedural pain and previous chronic pain conditions of the patient, in order to apply a specific therapeutic
approach. Available treatment recommendations emphasize the use of adaptive or dynamic analgesia,
with titration of analgesics according to changes in the clinical state of patients. They indicate the necessity
of pain assessment with tools for pain intensity assessment and therapy evaluation, as well as the need
for assessment at regular time intervals. Despite treatment guidelines, clinical practice shows significant
deviations from evidence-based recommendations. The reasons are primarily the non-recognition of pain,
insufficient knowledge of analgesics (type and dose), lack of regular assessment and inadequacy of the
applied tools for pain assessment. In terms of personalization, there is a need to develop objective pain
assessment methods, such as sensitive and pain-specific tools that do not rely on the patient’s ability to
communicate and are independent of assessors, disease characteristics and pharmacological interventions
in critically ill patients.
Keywords
pain; nociception; personalization; monitoring; intensive care medicine
Hrčak ID:
316569
URI
Publication date:
1.11.2023.
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