Mutual relationship between anxiety and pain in the intensive care unit and its effect on medications

Oh, Jae Young; Sohn, Jeong Hyun; Shin, Cheung Soo; Na, Se Hee; Yoon, Hongsik; Kim, Jae Jin; Park, Sunyoung; Park, Jin Young

doi:10.1016/j.jcrc.2015.05.025

Cited by 35 publications

(23 citation statements)

References 47 publications

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“…Endotracheal suctioning is a common method frequently used by nurses in intensive care units (ICUs) to maintain gas exchange, adequate oxygenation, and alveolar ventilation in patients under mechanical ventilation (1). Tracheal tube suctioning is a stressful and uncomfortable procedure and may cause complications such as vagal stimulation, increased respiratory rate, atelectasis, hypoxia, increased intracranial pressure, damage to the lining of the chip area, cardiac dysrhythmia, bleeding, and an increased risk of hospital-acquired infections.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial

2016

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BackgroundEndotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions.ObjectivesThe present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation.MethodsA randomized controlled clinical trial was conducted in the general intensive care units of Khatam-ol-Anbia hospital and Sina hospital, Tehran, Iran, in 2015. In total, 60 patients who were qualified to be included in the study were randomly assigned to either the intervention group or the control group. When necessary, suction was carried out for each patient using the standard technique. The patients’ level of pain and agitation was measured in both groups at five stages (before, during, immediately after, 5 minutes after, and 15 minutes after the intervention) using the behavioral pain scale and the Richmond agitation sedation scale.ResultsSignificant statistical differences in the pain and agitation at different times within each of the two groups were observed for both open and closed suction (P > 0.001). However, these changes at different times between the two groups was not significant (P < 0.05).ConclusionsAlthough statistical differences were observed in the levels of pain and agitation in the two groups, the type of suction system did not have any effect on the level of pain and agitation of patients under mechanical ventilation. The researchers recommend that other studies with larger sample sizes should be carried out.

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Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial

2016

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“…Both acute and chronic activation of the HPA and SAM axes have been shown to contribute to patient morbidity and mortality. Stress has been linked to immune suppression, gastrointestinal (GI) disease, cutaneous disease, delayed wound healing, and alterations in pain perception in human and veterinary patients . In human patients, it can also result in cardiovascular and neurologic dysfunction …”

Section: Adverse Consequences Of the Stress Responsementioning

confidence: 99%

Psychogenic stress in hospitalized veterinary patients: Causation, implications, and therapies

Lefman

Prittie

2019

J Vet Emergen Crit Care

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Objective: To review the sources, adverse effects, diagnosis, treatment, and prevention of psychogenic stress in hospitalized human and veterinary patients. Data Sources: Data were collected by searching PubMed for veterinary and human literature from the past 10 years. Human Data Synthesis: Psychogenic stress has been linked to immune suppression; gastrointestinal, cardiovascular, and cutaneous diseases; delayed wound healing; alterations in pain perception; and neurologic impairment. Sources of psychogenic stress include environmental alterations such as excessive noise and light, social and physical factors, sleep disruption, drugs, and underlying disease. Nonpharmacologic options for stress reduction include environmental and treatment modifications, music therapy, and early mobilization. Pharmacologic options include sedation with benzodiazepines and dexmedetomidine. Trazodone and melatonin have been examined for use in sleep promotion but are not currently recommended as standard treatments in ICU. Veterinary Data Synthesis: Activation of the stress response in veterinary patients is largely the same as in people, as are the affected body systems. Possible sources of stress can include social, physical, and environmental factors. No gold standard currently exists for the identification and quantification of stress. A combination of physical examination findings and the results of serum biochemistry, CBC, and biomarker testing can be used to support the diagnosis. Stress scales can be implemented to identify stressed patients and assess severity. Nonpharmacologic treatment options include low-stress handling, pheromones, environmental modifications, and sleep promotion. Pharmacologic options include trazodone, benzodiazepines, dexmedetomidine, and melatonin. Conclusion:The prevalence and clinical significance of psychogenic stress in hospitalized veterinary patients is unknown. Future studies are needed to specifically examine the causative factors of psychogenic stress and the effects of various therapies on stress reduction. The recognition and reduction of psychogenic stress in veterinary patients can lead to improvements in patient care and welfare.

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“…This discrimination is still a challenge for clinicians (144). In addition, correlations found between pain and anxiety (145), or pain, fear, and anxiety 146 is still used as a principal indicator for making decisions in pain management (144).…”

Section: Ethical Considerationsmentioning

confidence: 99%

Development of a pain management algorithm for intensive care units

et al. 2015

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Mutual relationship between anxiety and pain in the intensive care unit and its effect on medications

Cited by 35 publications

References 47 publications

Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial

Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial

Psychogenic stress in hospitalized veterinary patients: Causation, implications, and therapies

Development of a pain management algorithm for intensive care units

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