Persistent pain in intensive care survivors: a systematic review

Abstract

Background: According to earlier studies where the main aim has been quality of life, there is growing evidence of increased levels of persistent pain in survivors of critical illness. The cause of admission and several factors during intensive care may have associated risk factors for pain persistence. This systematic review aims to determine the incidence or prevalence of persistent pain after critical illness and to identify risk factors for it. Methods: Six databases were searched, and eventually nine studies were included in the final systematic process. The validity of observational and cross-sectional studies was analysed using the National Institute of Health 'Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies'. Results: The incidence of persistent pain after intensive care varied from 28% to 77%. Risk factors for persistent pain were acute pain at discharge from ICU, higher thoracic trauma score, surgery, pre-existing pain, organ failure, longer length of ventilator or hospital stay, and sepsis. No difference in incidence between medical and surgical patients was found. Conclusions: New systematic, observational studies are warranted to identify persistent pain-related factors in intensive care to improve pain management protocols and thereby diminish the risk of persistent pain after ICU stay.

Characteristics and influence on quality of life of new‐onset pain in critical COVID‐19 survivors

“…However, this success has come at the cost of increasing disability and decreasing survivors’ quality of life (QoL), which also impacts negatively on caregivers (Cameron et al, 2016 ; Herridge et al, 2003 , 2016 ; Torres et al, 2017 ). Critical illness survivors display a high prevalence of moderate to extreme chronic pain, with the latter entailing a significant limitation in work and social activity, and becoming a major cause of disability in Europe (Barbaglia et al, 2017 ; Baumbach et al, 2016 ; Mäkinen et al, 2020 ). Components of the PICS such as depression, anxiety, post‐traumatic stress disorder (PTSD) and cognitive impairment are also prevalent in chronic pain.…”

Fájdalomtünetek és a fájdalomcsillapítás lehetőségei SARS-CoV-2-környezetben

“…A hospitalizált betegekben 48 nappal az elbocsátás után a 6. leggyakoribb tünet volt a fájdalom, mely az intenzív terápiás osztályon kezelt betegek 30%-ánál, a nem intenzív osztályon kezelt betegek 15%-ánál jelentkezett [13]. A hason fektetett helyzet miatt a felső végtagi neuropathia/neuralgia gyakori, a súlyos és kritikus állapotú, intenzív terápiás osztályon kezelt betegeknél a leggyakoribb késői szövődmény, mely az elbocsátott betegek 14,4%-ánál jelentkezett [14,15]. Egy 143 betegre kiterjedő kohorsztanulmányban átlagos 60 napos utánkövetés alatt a betegek jelentős részénél ízületi fájdalom (27,3%) és mellkasi fájdalom (21,7%), illetve fejfájás és izomfájdalom szerepelt [11].…”

“…A COVID-19 neurotoxikus következményei komolyabbnak tűnnek megelőző idegrendszeri károsodások után (például szemet érintő herpes zoster és herpeszt követő neuralgia) egyébként egészséges egyénnél. A perzisztáló neuropathiás fájdalom prevalenciáját 28-77%-ra becsülik [14].…”

Survey of Opioid-Induced Respiratory Depression in Critically Ill Patients Without Mechanical Ventilation and Construction of a Risk Nomogram

“…Moderate-to-severe acute or chronic pain is experienced by 50-77% of patients in the intensive care unit (ICU) [1][2][3]. Severe pain is associated with changes in heart rate and blood pressure, dyspnea, respiratory distress, enhanced catabolism, and immune dysfunction and has adverse neuropsychologic effects such as anxiety, depression, and impaired sleep that result in poor outcomes for patients [4,5].…”