The Conundrum of Pain, Opiate Use, and Delirium: Analgosedation or Analgesia-First Approach?

Christina J Hayhurst^{1

2}, Christopher G Hughes^{1

2}, Pratik P Pandharipande^{1

2}

Affiliations

¹ Department of Anesthesiology Vanderbilt University Medical Center Nashville, Tennessee.
² Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center Vanderbilt University Medical Center Nashville, Tennessee.

Editorial

Christina J Hayhurst et al. Am J Respir Crit Care Med. 2021.

. 2021 Sep 1;204(5):502-503.

doi: 10.1164/rccm.202104-0968ED.

Christina J Hayhurst^{1

2}, Christopher G Hughes^{1

2}, Pratik P Pandharipande^{1

2}

¹ Department of Anesthesiology Vanderbilt University Medical Center Nashville, Tennessee.
² Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center Vanderbilt University Medical Center Nashville, Tennessee.

No abstract available

Comment on

Opioid Use Increases the Risk of Delirium in Critically Ill Adults Independently of Pain.
Duprey MS, Dijkstra-Kersten SMA, Zaal IJ, Briesacher BA, Saczynski JS, Griffith JL, Devlin JW, Slooter AJC. Duprey MS, et al. Am J Respir Crit Care Med. 2021 Sep 1;204(5):566-572. doi: 10.1164/rccm.202010-3794OC. Am J Respir Crit Care Med. 2021. PMID: 33835902 Free PMC article.

1. Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46:e825–e873. - PubMed
1. Shehabi Y, Bellomo R, Reade MC, Bailey M, Bass F, Howe B, et al. Sedation Practice in Intensive Care Evaluation (SPICE) Study Investigators; ANZICS Clinical Trials Group. Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med. 2012;186:724–731. - PubMed
1. Pandharipande P, Shintani A, Peterson J, Pun BT, Wilkinson GR, Dittus RS, et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology. 2006;104:21–26. - PubMed
1. Pun BT, Balas MC, Barnes-Daly MA, Thompson JL, Aldrich JM, Barr J, et al. Caring for critically ill patients with the ABCDEF bundle: results of the ICU Liberation Collaborative in over 15,000 adults. Crit Care Med. 2019;47:3–14. - PMC - PubMed
1. Morrison RS, Magaziner J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76–81. - PubMed