ASSESSMENT AND MANAGEMENT OF PAIN IN INTENSIVE CARE UNIT PATIENTS

Abstract

Pain is one of the most prevalent and debilitating symptoms in critical care patients, constituting a constant challenge for intensive care teams. Its assessment is particularly complex due to the high prevalence of patients with impaired verbal communication. Objective: To analyze current scientific evidence on pain assessment and management in intensive care unit patients, discussing measurement instruments, therapeutic strategies, and challenges in implementing analgesia protocols. Method: An integrative literature review conducted in the MEDLINE, LILACS, SciELO, CINAHL, and Cochrane Library databases. The PICO strategy guided the formulation of the research question. Articles published between 2019 and 2026 in Portuguese, English, and Spanish that addressed pain assessment and/or management in adult ICU patients were included. Results: The analysis showed that pain affects 50% to 80% of critically ill patients and is frequently underdiagnosed. The Behavioral Pain Scale and the Critical-Care Pain Observation Tool stood out as validated instruments for assessing pain in non-communicative patients. Evidence highlights multimodal analgesia strategies that integrate pharmacological and non-pharmacological interventions, prioritizing opioid reduction. The main barriers identified include the absence of institutional protocols, work overload, insufficient professional training, and a care culture focused on physiological parameters. Final considerations: A significant gap persists between theoretical knowledge and clinical practice in Brazilian ICUs. The implementation of standardized protocols, professional training, and cultural changes is essential to improve care quality and clinical outcomes.