Intravenous analgesia

Intravenous analgesics available to intensivists include opioids, ketamine, and the injectable nonsteroidal anti-inflammatory agent ketorolac. Practit ioners are updated on a potentially protective role for opioids in myocardi al ischemia, on recent studies of opioid-induced respiratory depression, an d on a newly investigated opioid antagonist and its potential role in the p revention of paralytic ileus. The suitability of ketamine as an analgesic a gent in critically ill patients is discussed. The results of its use by inf usion and in patients with hemodynamic and respiratory instability are pres ented. An emerging body of literature has increased our understanding of th e indications for ketorolac in the acute setting. Increased evidence has em erged for the ability of ketorolac to induce early-onset gastrotoxicity and renal failure. Additional information, on the other hand, supports its cos t-effective use following certain major surgeries.