Multimodal balanced analgesia in the critically ill.

Pain is common but is often undertreated in critically ill patients. A multimodal balanced analgesic approach is recommended for the management of pain in these patients. Balanced analgesia uses combined analgesic regimens, thereby reducing the likelihood of significant effects from a single agent or method. It may include several different drugs given to prevent or aggressively treat continuous and breakthrough pain as well as pain from procedures.

Analysis of pain content in nursing textbooks.

This paper reports on one goal of a project designed to improve end-of-life (EOL) care in nursing education. The goal was to improve the content regarding pain and EOL care included in major nursing textbooks. A descriptive study used content analysis of 50 textbooks selected from a potential of over 700 texts used in nursing education. The 50 texts included 45,683 pages. The text review was conducted using an analysis framework and included content analysis as well as quantification of the content present in the texts. While pain was the most common topic in the texts, the 248 pages of pain content represents only 0.5% of total text content. All nine areas of EOL content (902 pages) comprised only 2% of overall text. Particular weaknesses in the review of pain content were recognized in pharmacologic management of pain. In summary, nursing texts have limited content on pain. Increased attention to this area is essential to prepare nurses to care for patients at the end of life.