ICU sedation, delirium & recovery
The association between pain, analgesia, and delirium among critically ill adults: a systematic review and meta-analysis
Authors' conclusion
We observed an association between pain and incident delirium among critically ill adults. Exposure to morphine or fentanyl (but no other pain medications) was associated with increased risk of delirium occurrence.
Study context
- Population
- Critically ill adults
- Participants
- 119,230 adults · 90 studies
- Comparison
- Pain or analgesic exposure vs none, and delirium
- Outcome
- Prevalent delirium (occurrence)
Methodological detailsrandom effects model (Hartung-Knapp Sidik-Jonkmann), Risk of bias critical for many studies
- Random effects model (Hartung-Knapp Sidik-Jonkmann)
- Risk of bias critical for many studies
Pooled result
As reported in the abstract
Delirium occurrence
Odds ratio (95% CI)
Paintrend to association; 7 studies
2.49(0.98–6.30)
Fentanyl12 studies
2.49(1.45–4.27)
Morphine5 studies
2.13(1.21–3.75)
Further pooled results
Incident delirium
| OR (95% CI) | ||
|---|---|---|
| Pain | 3.70 (1.73–7.93) | |
| 0.10.31310Odds ratio (log scale) |
Original publication
The association between pain, analgesia, and delirium among critically ill adults: a systematic review and meta-analysis. Intensive Care Med. Published 22 January 2025. doi:10.
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