Maintaining comfort and analgesia is fundamental to providing adequate care in intensive care unit (ICU) patients. Pain assessment and its control remain the highest priorities and concerns among survivors of critical illness and their loved ones.

A single, dose-appropriate, intravenous (IV) opioid bolus should be considered for patients with severe pain or before a painful procedure.

Scheduled IV opioids (i.e., scheduled intermittent boluses and/or continuous infusions) are, and have been for decades, the mainstay of ICU analgesia. IV opioids were recommended as the first-choice analgesic for non-neuropathic pain in 2013 practice guidelines.

Their use remains prevalent both during and after ICU stay.

A current 29-country ICU point-prevalence study reports 87% of patients received scheduled IV opioids the previous day.

In another contemporaneous study in the United Kingdom (UK), 87.5% of ICU patients received continuous opioid infusions. Among opioid-naive Swedish ICU survivors, 5% took opioids chronically a year later

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