Comparative effectiveness data for one analgesia/sedation strategy versus another are lacking. The principles of medication use in the PFC setting include:

  1. Background: the pain that is always present because of an injury or wound. This should be managed to keep a patient comfortable at rest but should not impair breathing, circulation, or mental status.
  2. Breakthrough: the acute pain induced with movement or manipulation. This should be managed as needed. If breakthrough pain occurs often or while at rest, background pain medication should be increased.
  3. Procedural: the acute pain associated with a procedure. This should be anticipated and managed periprocedurally.