Pain Relief in the Intensive Care Unit

Treatment of severe pain in the intensive care unit first requires an assessment of pain type: nociceptive, cen tral, visceral, or referred. Narcotics given parenterally are the most commonly used agents for severe nocicep tive pain. Attention to potency, lipophilicity, route of administration, and side effects are all important. Cen tral nervous system pain may require nonnarcotic adju vants, anticonvulsants, or monoamine altering drugs for effective analgesia. The concomitance of emotional suf fering with the pain is an important problem to recog nize so that psychiatric disorders are properly treated.