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Ann Am Thorac Soc. 2018 Sep;15(9):1016-1023. doi: 10.1513/AnnalsATS.201801-028FR.

Critical Care Pain Management in Patients Affected by the Opioid Epidemic: A Review.

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1 Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; and.
2 Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois.


The rapid rise in the opioid epidemic has had a deleterious impact across the United States. This increase has drawn the attention of the critical care community not only because of the surge in acute opioid overdose-related admissions, but also due to the increase in the number of opioid-dependent and opioid-tolerant patients being treated in the intensive care unit (ICU). Opioid-related issues relevant to the critical care physician include direct care of patients with opioid overdoses, the provision of sufficient analgesia to patients with opioid dependence and tolerance, and the task of preventing long-term opioid dependence in patients who survive ICU care. This review identifies the challenges facing the ICU physician working with patients presenting with opioid-related complications, discusses current solutions, and suggests future areas of research and heightened ICU clinician attention.


intensive care unit; opioid epidemic; opioid tolerance; pain management

[Indexed for MEDLINE]

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