Unit:
Κατεύθυνση Αλγολογία: Αντιμετώπιση του πόνου, διάγνωση και θεραπεία. Φαρμακευτικές, παρεμβατικές και άλλες τεχνικέςLibrary of the School of Health Sciences
Author:
Maniamanis Dimitrios
Supervisors info:
Στάικου Χρυσούλα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ Επιβλέπουσα
Μελεμένη Αικατερίνη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σιδηροπούλου Τατιανή, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Χρόνιος πόνος μετά από νοσηλεία σε Μονάδες Εντατικής Θεραπείας. Βιβλιογραφική ανασκόπηση
Translated title:
Chronic pain after hospitalization in Intensive Care Unit. A literature review.
Summary:
OBJECTIVE: Patients admitted to Intensive Care Units (ICU) suffer from critical illness and have the highest mortality rates among hospitalized patients. For those who survive, recovery is often a prolonged rehabilitation period with physical, cognitive and psychological dysfunction. The aim of the present narrative review was to identify in the existing literature articles providing information about the development of chronic pain after ICU stay.
METHOD: We searched MEDLINE for relative articles. Finally, 41 articles were included in the present review; of them, 29 were original studies.
RESULTS: Pre-existing chronic pain, previous impairment in quality of life due to health problems, but also the critical illness itself and organ support with multiple interventions, predispose to the development of chronic pain in the post-critical period, making it difficult to return to the pre-disease functional status. Opioid administration during mechanical ventilation is a common practice, frequently without reliable or systematic assessment of pain and individualized titration of dosage. Multimodal analgesia, including dexmedetomidine, ketamine, adjuvant medication and regional analgesia techniques can prevent chronic pain and treat withdrawal symptoms during opioid weaning. Early mobilization and physiotherapy as soon as the patient’s condition becomes stable, continuous assessment of pain and its corresponding treatment during hospitalization and the following period, individualized titration of opioids and follow-up by a team of specialists during rehabilitation comprise a successful management plan for early recognition of complications and effective aftercare treatment of these patients.
CONCLUSIONS: Chronic pain after ICU stay is a common problem, associated with both critical illness and hospitalization itself. During rehabilitation, vigilance, care and an individualized multimodal analgesic regimen are required, in order to improve the quality of surviving patients’ lives.
Main subject category:
Health Sciences
Keywords:
Chronic pain, Critical illness, Intensive Care Unit, Survivors, Recovery
