MANAGEMENT OF PAIN IN MECHANICALLY VENTILATED PATIENTS

Contemporary analgesic techniques are available for use at each level of nonciception and pain perception. Interruption or modulation of aff erent input can be done systemically (parenteral opioids by intramuscu lar, subcutaneous, or intravenous injection; transdermal fentanyl; pat ient-controlled analgesia), at the spinal cord level (transcutaneous e lectrical nerve stimulation; subarachnoid or epidural administration o f local anesthetics, opioids or both), and in the periphery (nonsteroi dal-anti-inflammatory drugs; major nerve blocks).