Commentary Pain may be inevitable; inadequate management is not

Assessing and managing pain in the critically ill patient is challenging. Reproducible and clinically applicable pain measurement scales have yet to be validated and ubiquitously applied in the intensive care unit setting. Critical care clinicians, both physicians and nurses, should thoughtfully monitor their patient’s pain level, periodically reassess their practice and critically evaluate the efficacy of pharmacological and nonpharmacological analgesic interventions. Pain assessment is challenging. In the critical care setting, two factors interfere with such appraisals: the preoccupation with the disease process and the urgency of the necessary interventions on the part of the busy caregiver, on one hand; and the presumed inability of the patient to communicate, on the other. The recent study by Ahlers and colleagues is important because it demonstrates the latter may be largely untrue. The authors show that pain assessment can be performed in the majority of intensive care unit (ICU) patients – even if very ill – and that the scales available for its evaluation are useful [1]. All patients deserve to be pain free. ICU survivors rate