Pharmacological and nonpharmacological therapy for pain management in critically ill patients. Systematic review [Terapias farmacológicas y no farmacológicas en el manejo del dolor en pacientes críticos. Revisión sistemática]

Authors

DOI:

https://doi.org/10.62574/frj12277

Keywords:

intensive care, pain, pharmacological therapy, non-pharmacological therapy, pain scales

Abstract

Objective: To analyze pharmacological and non-pharmacological therapies in pain management in critically ill patients. Method: Documentary, qualitative and systematic review research, with a sample of 40 articles. Results and conclusions: Due to their analgesic potency, opioids remain the first-line analgesic. Morphine and fentanyl are the main opioids used in pain management. Adjuvants also stand out as a fundamental component of the analgesic approach to minimize opioid doses. Non-pharmacological treatment, on the other hand, seeks to reduce pain, improve cognitive function, reduce stress, etc. The main non-pharmacological therapies include music therapy, massage, family presence, and cryotherapy. Finally, the most commonly used scales in the ICU include the EVA, ESCID, BPS, and CPOT, as they offer multiple classification categories.

Downloads

Download data is not yet available.

References

Pérez J. Versión actualizada de la definición de dolor de la IASP: un paso adelante o un paso atrás [Updated version of the IASP definition of pain: A step forward or backward]. Rev Soc Esp Dolor. 2020;27(4). doi:10.20986/resed.2020.3839/2020.

Delgado G, Roca M, Vinces J, Borbor J. Manejo del dolor en paciente crítico [Pain management in critical patients]. Revi RECIMUNDO. 2022;6(3):487-496. Disponible en: https://n9.cl/zuyvs4.

Gallardo J, Córdova P, Valero M, Herrero A, Francés E, Barrera N. Manejo del dolor en pacientes ingresados en unidades de cuidados intensivos [Pain management in patients admitted to intensive care units]. Rev Sanitaria Investig. 2021. Disponible en: https://n9.cl/zuyvs4.

Hinarejos P. Manejo del dolor en el paciente crítico [Pain management in critical patients]. NPunto. 2023;VI(66):99-125. Disponible en: https://n9.cl/3207j.

González K, Fajardo H, Quiñonez M, Henao A. The meaning given to pain in critical patients by the nursing professional. Index Enferm. 2024;33(4):e15507. doi:10.58807/indexenferm20247055.

Vega J, Salinas V. Dolor crónico y su abordaje con el cannabidiol: una opción terapéutica [Chronic pain and its approach with cannabidiol: A therapeutic option]. CASEDELPO. 2024;284-296. doi:10.23857/pc.v9i3.6644.

Garg S, Garg P. Pain Control and Opioid Use in ICU should be a Quality Parameter. Indian J Crit Care Med. 2021;25(10):1205-1206. doi:10.5005/jp-journals-10071-23979.

Madrigal P, Cabañero E. Beneficios de la musicoterapia en el paciente crítico [Benefits of music therapy in critical patients]. Rev Med Enferm Ocronos. 2020;III(5):540. Disponible en: https://revistamedica.com/beneficios-musicoterapia-paciente-critico/.

Zakeri H, Mahtosh P, Radmehr M, Rahbani R, Montazeri L, Moalemi S, et al. Pain Management Strategies in Intensive Care Unit: Challenges and Best Practice. Galen Med J. 2024;13:e3264. doi:10.31661/gmj.v12i.3264.

Wojciechowski M, Marcondes L, Terassi M. Pain management: education of the adult Intensive Care Unit nursing. Braz J Pain. 2024;7:e20240038. doi:10.5935/2595-0118.20240038-en.

Pota V, Coppolino F, Barbarisi A, Passavanti M, Pasquale C, Pace M. Pain in Intensive Care: A Narrative Review. Pain Ther. 2022;(2):359-367. doi:10.1007/s40122-022-00366-0.

Motes A. Pain management in the intensive care unit. Southwest Respir Crit Care Chron. 2023;11(46):1-6. doi:10.12746/swrccc.v11i46.1133.

Tsegaye D, Yazew A, Gedfew M, Yilak G, Mengesha Z. Non-Pharmacological Pain Management Practice and Associated Factors Among Nurses Working at Comprehensive Specialized Hospitals. SAGE Open Nurs. 2023;9:23779608231158979. doi:10.1177/23779608231158979.

Wang Y, Aarón R, Attal N, Colloca L. An update on non-pharmacological interventions for pain relief. Cell Rep Med. 2025;6(2). doi:10.1016/j.xcrm.2025.101940.

Lia E, Pucci V, Raccagna C, Sebastiani S, Samolsky B. Analgosedation Management in the Intensive Care Unit: A Narrative Systematic Review. Open Anesth J. 2023. doi:10.2174/0125896458275320231120071303.

Kia Z, Allahbakhshian M, Ilkhani M, Nasiri M, Allahbakhshian A. Nurses’ use of non-pharmacological pain management methods in intensive. Complement Ther Med. 2021;58. doi:10.1016/j.ctim.2021.102705.

Nordness M, Hayhurst C, Pandharipande P. Current Perspectives on the Assessment and Management of Pain in the Intensive Care Unit. J Pain Res. 2021;14. Disponible en: https://www.tandfonline.com/doi/full/10.2147/JPR.S256406.

Sandvik R, Fosser B, Jorgen L, Moi A. Pain relief from nonpharmacological interventions in the intensive care unit: A scoping review. J Clin Nurs. 2020;29(9-10). doi:10.1111/jocn.15194.

Wang Y, Aarón R, Attal N, Colloca L. An update on non-pharmacological interventions for pain relief. Cell Rep Med. 2025;6(2). doi:10.1016/j.xcrm.2025.101940.

Guerrero M, Pérez O, Escarraman D, Ojeda A, Zamarron E, Olivares R, et al. Analgesia multimodal en el paciente crítico [Multimodal analgesia in critical patients]. Rev Chil Anest. 2023;52(2):177-192. doi:10.25237/revchilanestv5223121124.

Palacio M. El estrés en el paciente crítico. Realidad y cuidados de enfermería: Una revisión sistemática [Stress in critical patients. Reality and nursing care: A systematic review]. Conocim Enfermero. 2020;3(7):49-61. doi:10.60108/ce.94.

López C, Robleda G, Arranz A, Pérez T, Solís M, Sarabia M, et al. Desarrollo y validación psicométrica de la Escala de Conductas Indicadoras de Dolor-Daño Cerebral (ESCID-DC) para la evaluación del dolor en pacientes críticos con daño cerebral adquirido, incapaces de autoinformar y con vía aérea artificial [Development and psychometric validation of the Pain-Behavior Scale for Brain Damage (ESCID-DC) for assessing pain in critical patients with acquired brain damage, unable to self-report, and with artificial airways]. Enferm Intensiva. 2025;500-503. doi:10.1016/j.enfi.2025.500523.

Moreira J. Monitorización y evaluación del dolor en personas en estado crítico: una revisión integradora de la literatura [Monitoring and evaluation of pain in critically ill patients: An integrative literature review]. Rev Bras Rev Salu. 2023;1056-1072. doi:10.34119/bjhrv6n1-082.

Published

2025-05-08

Issue

Section

Originales breves

How to Cite

1.
Arciniega-Garrido LN, Moreira-Meza MG, Rodríguez-Merchán KA. Pharmacological and nonpharmacological therapy for pain management in critically ill patients. Systematic review [Terapias farmacológicas y no farmacológicas en el manejo del dolor en pacientes críticos. Revisión sistemática]. CER [Internet]. 2025 May 8 [cited 2026 Jul. 27];3(2):1-16. Available from: https://revistasinstitutoperspectivasglobales.rperspectivasinvestigativas.org/index.php/CER/article/view/641

Similar Articles

1-10 of 38

You may also start an advanced similarity search for this article.