BPS |
Payen et al.44 Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29(12):2258-63.
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Moderate to good internal consciousness22 Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abid K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg. 2005;101(5):1470-6.,99 Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioral Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs. 2006 Feb;22(1):32-9.,1414 Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg. 2010;110(1):127-33., agreement among surveyors from moderate to almost perfect44 Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29(12):2258-63.,99 Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioral Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs. 2006 Feb;22(1):32-9.,1414 Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg. 2010;110(1):127-33.. No significant correlation was found between the scale and the physiological variables 22 Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abid K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg. 2005;101(5):1470-6.. |
CPOT |
Gélinas et al.55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.
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Discriminating properties from moderate to good; good internal consistency11 Marmo L, Fowler S. Pain assessment tool in the critically ill post-open heart surgery patient population. Pain Manag Nurs. 2010;11(3):134-40.,2020 Paulson-Conger M, Leske J, Maidl C, Hanson A, Dziadulewicz L. Comparison of two pain assessment tools in nonverbal critical care patients. Pain Manag Nurs. 2011;12(4):218-24.; regular to almost perfect agreement among surveyors11 Marmo L, Fowler S. Pain assessment tool in the critically ill post-open heart surgery patient population. Pain Manag Nurs. 2010;11(3):134-40.,55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.,1919 Keane KM. Validity and reliability of the critical care pain observation tool: a replication study. Pain Manag Nurs. 2013;14(4):e216-e25.; during the painful stimulus it presented a sensitivity of 66.7-86%, specificity of 78-83.3% and accuracy of 63%1717 Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston C. Sensitivity and specificity of the Critical-Care Pain Observation Tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage. 2009;37(1):58-67.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.; a significant correlation between the self-reported pain and the CPOT score during the painful procedure55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.. The definition of the cut-off value during the painful procedure varied between >2 and >31717 Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston C. Sensitivity and specificity of the Critical-Care Pain Observation Tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage. 2009;37(1):58-67.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.. Highest CPOT scores during and immediately after a painful procedure55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1616 Lee K, Oh H, Suh Y, Seo W. Patterns and clinical correlates of pain among brain injury patients in critical care assessed with the Critical Care Pain Observation Tool. Pain Manag Nurs. 2013;14(4):259-67.. After the tool implementation, there was a higher frequency of pain reassessment, of pain episodes, and lower number of complications1515 Arbour C, Gélinas C, Michaud C. Impact of the implementation of the Critical Care Pain Observation Tool (CPOT) on pain management and clinical outcomes in mechanically ventilated trauma intensive care unit patients: a pilot study. J Trauma Nurs. 2011;18(1):52-60.. |
NCS/ NCS-R |
Schnakers et al.77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9./ Chatelle et al.88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.
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There was a significant difference in the diagnosis of vegetative state and minimum consciousness state77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9.,88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.. With the ROC curve analysis, the following cut-off values were defined for the NCS: <2 no pain, 2-3 possible presence of pain, and ≥3 probable presence of pain. The NCS-R cut-off values were: <1 no pain, 1-2 possible presence of pain, and ≥2 probable presence of pain. NCS: moderate to good agreement between surveyors77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9.,2121 Riganello F, Cortese MD, Arcuri F, Candelieri A, Guglielmino F, Dolce G, et al. A study of reliability of the Nociception Coma Scale. Clin Rehabil. 2015;29(4):388-93.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.; sensitivity 46-73.6%, specificity 67.3-97% and accuracy 72%88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.. NCS-R: good agreement among surveyors22; sensitivity of 73-76.7%, specificity of 74.7-97% and accuracy of 85%88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.. |