ANALGESIC, ANALGESIA
MORPHINE, FENTANYL, FENTANYL PATCH;
BOLUS ADMISTRATION

An analgesic is a drug that relieves pain. Analgesia is the absence of pain. Analgesics are used to produce analgesia.

There are many sources for patient pain and discomfort within a critical care environment. Procedural pain, invasive tubes and bed-rest are examples of causes for patient discomfort. Pain is monitored continuously in CCTC and is treated as needed. Pain medication requirements vary from patient to patient.

Narcotics are the most commonly used pain relievers in CCTC. They work quickly and provide effective relieve for moderate and severe pain. Morphine and fentanyl are the most commonly used narcotics. These are usually given directly into the patient's bloodstream though an intravenous. Intravenous medications are used because they work immediately and eliminate the need to pick the patient with needles.

Intravenous doses that are given intermittently are called "boluses" (Image 1). An intravenous bolus works immediately, and provides pain relief for a short period of time. If a patient has severe pain, or requires frequent bolus administration, pain medications may be given by continuous intravenous infusion by an infusion pump.

As patients begin to recover from an acute illness, patients may be switched to oral medications such as acetaminophen (Tylenol), non-steroidal anti-inflammatories or oral narcotics. They may be given into a feeding tube if the patient is unable to swallow (for example, due to a breathing tube). For consistent long term pain control, narcotic skin patches, such as fentanyl patches may be used. These are changed every 2-3 days, allowing for steady, slow absorption of the drug into the skin (Image 2).

Other methods of pain control include Patient Controlled Analgesia (PCA) and epidural pain relieve.

Image 1 : Administration of Intravenous Bolus

Image 2 : Fentanyl Patch