The Critical Conundrum: Balancing Pain and Opioid Use in Critical Illness
Book Title
Substance Use Disorders in Adult Critically Ill Patients
Files
Description
Opioid use is widespread throughout the intensive care unit. Opioids are prescribed for analgesia and/or sedation to tolerate mechanical ventilation, but both undertreating pain and overusing opioids can lead to considerable adverse effects in critically ill patients. Clinicians must consider many factors when administering opioids in critical illness, including patients’ history of chronic pain and outpatient opioid use, pain associated with their acute diagnoses, surgery, and invasive procedures, as well as tolerance of mechanical ventilation. Underutilization of opioids may yield unmanaged pain, which may manifest as post-traumatic stress disorder in ICU survivors. Aggressive weaning of opioids may risk iatrogenic opioid withdrawal. Conversely, evidence is growing that supports potential harms from opioid use in critical illness, including new persistent opioid use and new chronic pain diagnoses after discharge. This chapter provides a comprehensive review of the risks and benefits of opioid use in the ICU.
First Page
57
Last Page
77
ISBN
9783031670695
Publication Date
10-25-2024
Publisher
Springer, Cham
City
Switzerland
Keywords
Opioid
Disciplines
Anesthesiology
Recommended Citation
Jarzebowski ML, Laney M. The critical conundrum: balancing pain and opioid use in critical illness. In: Karamchandani K, Grant JE, eds. Substance use disorders in adult critically ill patients. Switzerland: Springer, Cham; 2024. p.57-77. doi: 10.1007/978-3-031-67069-5.