Pain may be inevitable; inadequate management is not 英文参考文献.docVIP

Available online /content/12/2/142 Commentary Pain may be inevitable; inadequate management is not Yoanna Skrobik H?pital Maisonneuve Rosemont, 5415 boulevard de l’Assomption, Montreal, Québec, Canada H1T 2M4 Corresponding author: Yoanna Skrobik, skrobik@sympatico.ca Published: 29 April 2008 Critical Care 2008, 12:142 (doi:10.1186/cc6865) This article is online at /content/12/2/142 ? 2008 BioMed Central Ltd See related research by Ahlers et al., /content/12/1/R15 Abstract performed at rest; pain upon mobilization or coughing is not verified. In addition, whether sedative drugs or ICU delirium cloud the ability of the patient to convey the presence or the degree of pain is unknown. Assessing and managing pain in the critically ill patient is challenging. Reproducible and clinically applicable pain measure- ment scales have yet to be validated and ubiquitously applied in the intensive care unit setting. Critical care clinicians, both physicians and nurses, should thoughtfully monitor their patient’s pain level, periodically reassess their practice and critically evaluate the efficacy of pharmacological and nonpharmacological analgesic interventions. There is huge interindividual variability in both the pain threshold and the sensitivity to various analgesic drugs in postoperative patients [6]. Such variability is at least as great in the ICU. This variability makes assessment necessary, as without assessment the individual variability in pain Pain assessment is challenging. In the critical care setting, two factors interfere with such appraisals: the preoccupation with the disease process and the urgency of the necessary interventions on the part of the busy caregiver, on one hand; and the presumed inability of the patient to communicate, on the other. The recent study by Ahlers and colleagues is important because it demonstrates the