Department of Neurology, VU Medical Center, De Boelelaan 1117, Amsterdam, The Netherlands,
Neurocrit Care. 2013 Oct;19(2):232-56. doi: 10.1007/s12028-013-9851-0.
The core challenge of pain management in neurocritical care is to keep the patient comfortable without masking or overlooking any neurological deterioration. Clearly in patients with a neurological problem there is a conflict of clinical judgement and adequate pain relief. Here we review the presentation, assessment, and development of pain in the clinical spectrum of patients with associated neurological problems seen in a general intensive care setting. Many conditions predispose to the development of chronic pain. There is evidence that swift and targeted pain management may improve the outcome. Importantly pain management is multidisciplinary. The available non-invasive, pharmacological, and invasive treatment strategies are discussed.
神经危重症患者的疼痛管理的核心挑战是在不掩盖或忽视任何神经恶化的情况下让患者感到舒适。显然，对于存在神经问题的患者，临床判断和充分的疼痛缓解之间存在冲突。在这里，我们回顾了在普通重症监护病房中遇到的伴有神经问题的患者的临床谱中疼痛的表现、评估和发展。许多情况会导致慢性疼痛的发生。有证据表明，迅速和有针对性的疼痛管理可以改善预后。重要的是，疼痛管理是多学科的。讨论了可用的非侵入性、药物和侵入性治疗策略。
