Table 1.

Non-Opioid Analgesics for the ICU

Drug	Dose	Metabolism/Clearance	Considerations
Acetaminophen	<4 g/d	Hepatic	Dose adjust for cirrhosis: up to 2g/d
Gabapentinoids Gabapentin Pregabalin	100–1200 mgTID 50–300 mg TID	Renal	Dose adjust for GFR; Commonly can cause somnolence, blurry vision
Ketamine Infusion	2–5 mcg/kg/min	Hepatic	Avoid if history of PTSD/psychosis due to risk of hallucinations
Lidocaine Infusion*	1–2 mg/min	Hepatic	Avoid if history of seizure disorder, on anti-arrhythmics
NSAIDs*	Varies	Renal	Caution with reduced GFR, peptic ulcers, age >65
SNRIs*	Varies	Hepatic	Analgesic effect is faster onset than anti-depressant effect; helps with anxiety component

Note: *Not recommended for routine use by SCCM.³

Abbreviations: TID, three times daily; GFR, glomerular filtration rate; PTSD, post-traumatic stress disorder; NSAIDs, non-steroidal anti-inflammatory drugs; SNRIs, serotonin/norepinephrine reuptake inhibitors.