Pain in the intensive care unit: Recognition, measurement, management

There has been a resurgence in interest in the in-hospital management of pa in, largely related to results of investigations into the role of analgesia in outcome and cost-efficiency The traditional aim of analgesia as simply an altruistic goal has been supplanted by the goal of impacting on the alte red physiology accompanying critical illness and trauma. Elucidation of the effect of pain and the accompanying stress response on pulmonary dysfuncti on in particular, but also on myocardial ischemia and coagulation, has sugg ested that the provision of adequate analgesia by rime-honored methods may not in itself effect a reduction in morbidity without attention to the meth od of analgesic delivery and choice of agent.