SCCM Resource Library-Pro/Con Debate: PADIS Guidelines: Always Use Narcotics?

Video Transcription

Video Summary

The debate revolved around the use of opioids for pain management in critically ill patients. Dr. Karamchandani argued in favor of opioids, highlighting the high incidence of pain in the ICU and the need for effective pain management. He also discussed different types of pain patients experience and the challenges of assessing pain in the ICU. Dr. Bittner countered with concerns about the adverse effects of opioids, such as tolerance, hyperalgesia, withdrawal, dependence, and chronic pain. He emphasized the importance of multimodal analgesia and non-opioid alternatives. He also discussed the potential risks of opioid-induced hyperalgesia and opioid withdrawal. The debate touched on the use of fentanyl as sedation, the comparison between clonidine and dexmedetomidine, and the practice of rotating patients from fentanyl to hydromorphone. There was also discussion about the transition from infusions to oral opioids as patients are discharged from the ICU. Both panelists agreed on the need for individualized pain management plans, careful assessment of pain, and the importance of minimizing opioid use and considering non-opioid alternatives.

Asset Subtitle

Pharmacology, Quality and Patient Safety, 2020

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2020 Critical Care Congress held February 16-19, 2020, in Orlando, Florida, USA.

Learning Objectives:

Review application of the new pain, agitation/sedation, delirium, immobility, and sleep disruption (PADIS) guidelines
Review differences in patients related to need for narcotics
Illustrate potential differences in narcotic recommendations

Pro: Always Use Narcotics

Kunal Karamchandani

Always Use Narcotics - Con

Edward A. Bittner

Meta Tag

Content Type Presentation

Knowledge Area Pharmacology

Knowledge Area Quality and Patient Safety

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Analgesia and Sedation

Tag Guidelines

Year 2020

Keywords

opioids

pain management

critically ill patients

ICU

assessing pain

non-opioid alternatives

multimodal analgesia

opioid-induced hyperalgesia

individualized pain management plans

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