Management of pain in intensive care settings

Analgesic modalities exist for use at each level of nociception and pain perception. Interruption or modulation of afferent nerve input can be done in the periphery (e.g., nonsteroidal anti-inflammatory drugs and major nerve or plexus block), at the spinal cord level (e.g., epidural opioids and local anesthetics), or systemically (e.g., intravenous opioids by bolus, infusion, or patient controlled analgesia). These techniques significantly can improve patient outcome and comfort.