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Prescribing nonopioids in mechanically ventilated critically ill patients
- Source :
- Journal of Critical Care, Journal of Critical Care, WB Saunders, 2013, 28 (4), pp.534.e7-534.e12. ⟨10.1016/j.jcrc.2012.10.006⟩
- Publication Year :
- 2013
- Publisher :
- HAL CCSD, 2013.
-
Abstract
- Purpose We searched for factors independently associated with the prescription of multimodal (balanced) analgesia in mechanically ventilated critically ill patients. Methods In this post hoc analysis of a cohort study, 172 patients who received a combination of 1 opioid with nonopioids, that is, paracetamol and/or nefopam, (multimodal analgesia), were compared with 302 patients who received opioid only on day 2 of their stay in the intensive care unit. Results Patients given multimodal analgesia were more likely to have fewer organ failures and received fewer hypnotics compared with patients who received opioid only. They self-reported more frequently their pain level. There were no differences in the daily dose of opioids between the 2 groups. A low illness severity score, no more than 1 organ failure on day 2, the ability to self-rate pain, and a moderate-to-severe pain rated on day 2 were factors independently associated with the prescription of multimodal analgesia on day 2 (all P Conclusions In mechanically ventilated patients, the addition of nonopioids to opioids is mostly prescribed for patients with lower illness severity scores and who are able to self-rate their pain intensity. These findings suggest that the concept of multimodal analgesia must be promoted in the intensive care unit.
- Subjects :
- Adult
Male
Critical Illness
Sedation
[SDV]Life Sciences [q-bio]
Critical Care and Intensive Care Medicine
Severity of Illness Index
Statistics, Nonparametric
law.invention
03 medical and health sciences
0302 clinical medicine
Nefopam
030202 anesthesiology
law
Post-hoc analysis
medicine
Humans
Pain Management
Practice Patterns, Physicians'
Medical prescription
ComputingMilieux_MISCELLANEOUS
Acetaminophen
Aged
Pain Measurement
Chi-Square Distribution
business.industry
Critically ill
Analgesics, Non-Narcotic
Middle Aged
[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences
Respiration, Artificial
Intensive care unit
3. Good health
Analgesics, Opioid
Intensive Care Units
Logistic Models
Opioid
Anesthesia
Drug Therapy, Combination
Female
medicine.symptom
business
030217 neurology & neurosurgery
Cohort study
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 08839441
- Database :
- OpenAIRE
- Journal :
- Journal of Critical Care, Journal of Critical Care, WB Saunders, 2013, 28 (4), pp.534.e7-534.e12. ⟨10.1016/j.jcrc.2012.10.006⟩
- Accession number :
- edsair.doi.dedup.....ce7d7eab24d66c7ef5598d9b54f3fb46