The application of nerve blocks in intensive care units

Pain management is still one of the key problems in medicine, and it remains a challenge for intensive care unit (ICU) patients. Both the overtreatment and undertreatment of pain can have adverse effects. Monomodal analgesic approaches, such as intravenous analgesia, are one of the most prevalent methods for pain management. However, excessive reliance on intravenous medications, particularly opioids, can result in various side effects, including respiratory insufficiency, prolonged mechanical ventilation, delayed extubation, gastrointestinal dysfunction, and slowed neuromuscular recovery. Hence, it is imperative to reduce the use of intravenous analgesia. Nerve block analgesia, which leverages anatomical landmarks or ultrasound guidance, is a critical component of multimodal analgesic approaches for managing pain among critically ill patients. This method offers superior pain relief compared to systemic treatments and is associated with a reduced incidence of adverse effects. However, despite its benefits, nerve block analgesia remains underutilized in ICUs. Therefore, in this article, we explore the application of nerve blocks in ICUs, investigating common methods and indications for pain management.