Department of Clinical Nursing, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, 31-501 Kraków, Poland.
Department of Anaesthesiology and Intensive Therapy, University Hospital in Kraków, 30-688 Kraków, Poland.
Int J Environ Res Public Health. 2022 Sep 1;19(17):10894. doi: 10.3390/ijerph191710894.
Intensive Care Unit (ICU) patients often experience pain, especially during diagnostic, nursing, and therapeutic interventions. Pain assessment using the Behavioral Pain Scale (BPS) and Critical Care Pain Observation Tool (CCPOT) are recommended, but they are difficult to do in patients undergoing deep sedation. This study analyzed the usefulness of the BPS and CCPOT scales in assessing pain among patients with varying degrees of sedation.
In 81 mechanically ventilated and sedated ICU patients, 1005 measurements were performed using the BPS and CCPOT scales. The study was conducted by 3 trained observers 3 times a day (each measurement at rest, during painful nursing interventions, and after the intervention). The Richmond Agitation-Sedation Scale (RASS), the Simplified Acute Physiology Score (SAPS II), and the Acute Physiology and Chronic Health Evaluation (APACHE II) were also analyzed from medical records as well as information on the length of hospitalization and treatment.
It was shown that signs of pain increased significantly ( < 0.001) during interventions in patients on both scales (BPS and CCPOT), and then returned to values close to the resting period. RASS results correlated significantly ( < 0.05) and positively with the results of the BPS and CCPOT. A strong correlation was found between the results of both scales at each stage of the study (R = 0.622-0.907).
Nursing procedures are a source of pain in analgosedated patients. The BPS and CCPOT scales are useful tools for assessing the occurrence of pain in mechanically ventilated patients, including those in deep sedation.
重症监护病房（ICU）的患者经常会感到疼痛，尤其是在接受诊断、护理和治疗干预时。推荐使用行为疼痛量表（BPS）和重症监护疼痛观察工具（CCPOT）来评估疼痛，但在深度镇静的患者中，这些方法很难实施。本研究分析了 BPS 和 CCPOT 量表在评估不同镇静程度患者疼痛中的有用性。
在 81 名接受机械通气和镇静治疗的 ICU 患者中，使用 BPS 和 CCPOT 量表进行了 1005 次测量。由 3 名经过培训的观察者每天进行 3 次测量（每次测量均在休息时、进行疼痛护理干预时和干预后进行）。还从病历中分析了 Richmond 躁动镇静量表（RASS）、简化急性生理学评分（SAPS II）和急性生理学和慢性健康评估（APACHE II），以及住院时间和治疗信息。
结果显示，在两种量表（BPS 和 CCPOT）中，患者在干预期间疼痛迹象显著增加（<0.001），然后恢复到接近休息时的值。RASS 结果与 BPS 和 CCPOT 的结果显著相关（<0.05）且呈正相关。在研究的每个阶段，两种量表的结果之间都存在很强的相关性（R = 0.622-0.907）。
护理程序是镇静患者疼痛的一个来源。BPS 和 CCPOT 量表是评估机械通气患者疼痛发生情况的有用工具，包括深度镇静患者。
