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World J Clin Cases. Feb 16, 2022; 10(5): 1473-1484
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1473
Management of procedural pain in the intensive care unit
Na-Na Guo, Hong-Liang Wang, Ming-Yan Zhao, Jian-Guo Li, Hai-Tao Liu, Ting-Xin Zhang, Xin-Yu Zhang, Yi-Jun Chu, Kai-Jiang Yu, Chang-Song Wang
Na-Na Guo, Hai-Tao Liu, Xin-Yu Zhang, Yi-Jun Chu, Chang-Song Wang, Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Hong-Liang Wang, Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Ming-Yan Zhao, Kai-Jiang Yu, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Jian-Guo Li, Department of Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
Ting-Xin Zhang, Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Author contributions: Wang CS and Yu KJ provided design and guidance; Guo NN, Zhang TX, Zhang XY and Chu YJ consulted the literature and completed the writing; Wang HL, Zhao MY, Li JG and Liu HT assisted in the literature review; all authors read and approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Song Wang, PhD, Professor, Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin 150081, Heilongjiang Province, China. changsongwangicu@163.com
Received: February 3, 2021
Peer-review started: February 3, 2021
First decision: July 16, 2021
Revised: July 22, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 16, 2022
Processing time: 372 Days and 14.7 Hours
Abstract

Pain is a common experience for inpatients, and intensive care unit (ICU) patients undergo more pain than other departmental patients, with an incidence of 50% at rest and up to 80% during common care procedures. At present, the management of persistent pain in ICU patients has attracted considerable attention, and there are many related clinical studies and guidelines. However, the management of transient pain caused by certain ICU procedures has not received sufficient attention. We reviewed the different management strategies for procedural pain in the ICU and reached a conclusion. Pain management is a process of continuous quality improvement that requires multidisciplinary team cooperation, pain-related training of all relevant personnel, effective relief of all kinds of pain, and improvement of patients' quality of life. In clinical work, which involves complex and diverse patients, we should pay attention to the following points for procedural pain: (1) Consider not only the patient's persistent pain but also his or her procedural pain; (2) Conduct multimodal pain management; (3) Provide combined sedation on the basis of pain management; and (4) Perform individualized pain management. Until now, the pain management of procedural pain in the ICU has not attracted extensive attention. Therefore, we expect additional studies to solve the existing problems of procedural pain management in the ICU.

Keywords: Procedural pain; Persistent pain; Transient pain; Pain management; Topical anesthesia; Intensive care unit

Core Tip: In clinical work, which involves complex and diverse patients, we should pay attention to the following points for procedural pain: (1) Consider not only the patient's persistent pain but also his or her procedural pain; (2) Conduct multimodal pain management; (3) Provide combined sedation on the basis of pain management; and (4) Perform individualized pain management.