Pain is among the most common symptoms reported by intensive care unit (ICU) patients. Within the pediatric ICU (PICU), nearly 90% of children undergo at least 1 painful procedure. Effective pain management is a cornerstone of high-quality PICU care, as poorly managed pain can blunt immune responses, elicit cardiovascular stress, disrupt sleep, and potentiate long-term psychiatric morbidity. Although self-report is the reference-standard method of evaluating a child’s pain, clinicians rely on behavioral assessments when children are unable to communicate. However, when PICU patients require neuromuscular blockade (NMB) as a means of optimizing mechanical ventilation, they are physically unable to vocalize or exhibit signs of behavioral pain. Currently, no valid methods exist to measure pain in children undergoing NMB. Physiologic parameters like blood pressure, heart rate, pupillary dilatation, and diaphoresis may be used to infer pain in noncommunicative patients but are limited because they may change in response to other factors...
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Evidence-Based Review and Discussion Points| September 01 2023
Discussion Guide for the Laures Article
Am J Crit Care (2023) 32 (5): 355–356.
Grant A. Pignatiello; Discussion Guide for the Laures Article. Am J Crit Care 1 September 2023; 32 (5): 355–356. doi: https://doi.org/10.4037/ajcc2023696
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