Persistent pain — which is common in survivors of critical illnesses — may not be associated with opioid exposure during intensive care unit (ICU) stays, according to a study published in Anesthesia & Analgesia.

The brief pain inventory (BPI) was administered to 295 adult survivors of critical illness by blinded neuropsychology professionals to evaluate pain intensity and pain interference with daily living at 3 months and 12 months post-ICU discharge. Cumulative exposure to opioids in the ICU (for both analgesia and sedation) was assessed via a review of medical records.

Persistent pain and pain interference with daily living were reported at 3- and 12-month follow-up (pain, 77% and 74% of patients, respectively; pain interference, 59% and 62%, respectively). The median pain intensity score was 3 on a scale of 1 to 10 (mild pain), and the median overall pain interference score was 2 at 3- and 12-month follow-up.

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Patients who were exposed to opioids during their ICU stay did not report increased pain intensity at 3- or 12-month follow-up (3 months: odds ratio [OR], 2.12; 95% CI, 0.92- 4.93; P =.18; 12 months: OR, 2.58; 95% CI, 1.26-5.29; P =.04) or increased pain interference in daily life (3 months: OR, 1.48; 95% CI, 0.65-3.38; P =.64; 12 months: OR, 1.46; 95% CI. 0.72-2.96; P =.58).

Findings from this study may not generalize to patients in non-academic hospital settings, and reliable pain scores could not be obtained in some nonverbal critically ill patients.

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“We observed that pain after ICU discharge interferes with the ability to function normally in daily life, and thus, is likely to affect post-ICU quality of life,” concluded the study authors. “While disability can be unavoidable in some ICU patients, addressing persistent pain symptoms as a long-term cause of functional impairment may improve long-term outcomes,” they added.

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style=”line-height: 115%; border: none;”>Hayhurst CJ, Jackson JC, Archer KR, et al. Pain and its long-term interference of daily life after critical illness [published online April 11, 2018]. Anesth Analg. doi:10.1213/ANE.0000000000003358