Postoperative pain management in the critically ill patient is a challenge for nurses. Knowing the basis of pain transmission and mechanisms of action of interventions can assist the critical care nurse in making clinical decisions regarding pain control for individual patients. There are a number of modalities available to treat postoperative pain including both pharmacologic and nonpharmacologic interventions. Techniques such as PCA not only can provide good analgesia, but allow the critically ill patient at least one aspect of control in the otherwise highly controlled environment of the critical care unit. Epidural or intrathecal analgesia, using either opioids or LAAs alone or in combination, provides excellent analgesic effect (with minimal side effects) and may improve patient outcomes. Nonpharmacologic techniques, unfortunately, are commonly overlooked as adjuncts to traditional analgesia routines because of the nature of the illness in the critically ill patient. Nonpharmacologic techniques of pain management have a place in the care of the critically ill when applied based on the assessment of an individual patient's needs and abilities to participate in his or her care. Ensuring optimal patient comfort can benefit critically ill patients and improve clinical outcomes.
对重症患者进行术后疼痛管理对护士来说是一项挑战。了解疼痛传导的基础以及干预措施的作用机制有助于重症护理护士就个体患者的疼痛控制做出临床决策。有多种方式可用于治疗术后疼痛，包括药物和非药物干预。诸如患者自控镇痛（PCA）等技术不仅能提供良好的镇痛效果，还能让重症患者在重症监护病房高度受控的环境中至少拥有一个可控制的方面。单独或联合使用阿片类药物或局部麻醉药的硬膜外或鞘内镇痛具有出色的镇痛效果（副作用最小），并可能改善患者的预后。不幸的是，由于重症患者疾病的性质，非药物技术通常被忽视，未能作为传统镇痛方案的辅助手段。基于对个体患者参与自身护理的需求和能力的评估应用疼痛管理的非药物技术，在重症患者的护理中占有一席之地。确保患者达到最佳舒适度可使重症患者受益并改善临床预后。
