Pain among non-verbal critically Ill mechanically ventilated patients: Prevalence, correlates and predictors.

PURPOSE

To investigate pain levels and factors that are predictive of pain for mechanically ventilated patients during rest and during routine nursing procedures.

MATERIAL AND METHODS

Pain levels were assessed using Behavioral Pain Scale (BPS) and physiological measures among 247 mechanically ventilated patients.

RESULTS

At rest, 33.2% of patients suffered pain, with a BPS > 3; of these, 10% presented significant pain levels (BPS ≥ 5). Variables that correspondingly predicted resting pain were age (β = -0.010, p < 0.001), sedation score (β = -0.153, p < 0.01), and method of ventilation (β = -0.281, p = 0.021). During the procedures, 90% of patients suffered pain, with a median BPS of 6 (IQR: 4-8), and 83% of patients experienced significant pain levels. Age (β = -0.022, p = 0.001), sedation score (β = -0.355, p < 0.001), receiving sedation and/or analgesia in last hour (β = 0.483, p = 0. 01), resting pain levels (β = -0.742, p < 0.001) and the type of painful procedure (β = -0.906, p < 0.001) were significant predictors of procedural pain.

CONCLUSIONS

Many mechanically ventilated patients suffer resting and procedural pain. Many variables were found to play a role. Clinicians need to consider these variables and intervene to decrease pain among patients at risk.