pain management

In neuro patients with altered LOC, with and without ICP monitoring, how is pain addressed and/or managed? What is your neurosurgeon's philosophy on interpretation of pain in the patient with altered LOC?

[Kiwes]

We never treat our neurosurgical patients for pain with any narcotics. They get Tylenol or another NSAID (depending on risk of bleed).

[zenith]

I work on a neurosurgery/trauma unit and I would say that each neurosurgeon/ trauma MD has his/her own recipe for pain management. Some like to medicate patients with ALOC, some don't. Generally, we determine pain of

apatient who is ALOC or comatose by baseline vitals or asking family about pt's usual pain tolerance. After consulting with the doctor, we may titrate Morphine or Demerol. TKS, Zenith