Chronic pain and chronic opioid use after intensive care discharge - Is it time to change practice?

Dusica M. Stamenkovic, Helen Laycock, Menelaos Karanikolas, Nebojsa Gojko Ladjevic, Vojislava Neskovic, Carsten Bantel

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Almost half of patients treated on intensive care unit (ICU) experience moderate to severe pain. Managing pain in the critically ill patient is challenging, as their pain is complex with multiple causes. Pharmacological treatment often focuses on opioids, and over a prolonged admission this can represent high cumulative doses which risk opioid dependence at discharge. Despite analgesia the incidence of chronic pain after treatment on ICU is high ranging from 33-73%. Measures need to be taken to prevent the transition from acute to chronic pain, whilst avoiding opioid overuse. This narrative review discusses preventive measures for the development of chronic pain in ICU patients. It considers a number of strategies that can be employed including non-opioid analgesics, regional analgesia, and non-pharmacological methods. We reason that individualized pain management plans should become the cornerstone for critically ill patients to facilitate physical and psychological well being after discharge from critical care and hospital.

Original languageEnglish
Article number23
JournalFrontiers in Pharmacology
Volume10
Issue numberfebuary
DOIs
StatePublished - Jan 1 2019

Keywords

  • Analgesics
  • Chronic pain
  • Critical care
  • Opioids
  • Pain

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