Critically ill patients on mechanical ventilation are frequently managed with sedative and analgesics. Pain is a very common experience in the ICU. Failure to recognize pain leads to agitation and increase use of sedatives. Majority of patients find even routine ICU procedures uncomfortable and painful. Inability to communicate about pain due to presence of an endotracheal tube may lead to high levels of anxiety and may precipitate development of posttraumatic stress disorder. Now it is recommended to aggressively manage pain.