Berré J
Resuscitation. 1984 Mar;11(3-4):157-64. doi: 10.1016/0300-9572(84)90013-3.
Many critically ill patients suffer pain which can produce by itself undesirable effects. Consequently, pain must be carefully prevented, or at least, treated early and effectively. Basal analgesia can be provided by repeated intramuscular administration of narcotics, or rather by continuous intravenous infusion of morphine or meperidine or by a regional anesthetic procedure such as an epidural block. Computer-assisted intravenous "on demand" analgesia with Fentanyl can also be used. When pain coverage is required during transient events such as active physiotherapy or dressing changes, additional intravenous of a narcotic (1-2 mg morphine e.g.) or inhalation of nitrous oxide with oxygen are usually effective.
许多重症患者会遭受疼痛,而疼痛本身会产生不良影响。因此,必须谨慎预防疼痛,或者至少要尽早且有效地进行治疗。基础镇痛可通过反复肌肉注射麻醉剂来实现,或者更确切地说是通过持续静脉输注吗啡或哌替啶,或者采用区域麻醉方法,如硬膜外阻滞。也可使用计算机辅助静脉“按需”给予芬太尼镇痛。当在诸如主动物理治疗或更换敷料等短暂事件期间需要疼痛覆盖时,额外静脉注射一种麻醉剂(例如1 - 2毫克吗啡)或吸入一氧化二氮与氧气的混合气通常是有效的。