Pain Assessment in the Intensive Care Unit

Study Overview
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Brief Summary
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Pain assessment using self-report scales (Visual Analogue Scale, Numerical Rating Scale), is recommended in the general population, however it is not always possible in patients with altered neurological status such as sedated patients or patients with delirium. Consequently, pain assessment is highly challenging in these ICU patients. This is a prospective observational study assessing 3 behavioral pain scales in the ICU. The hypothesis of this proposal is that one of the three ICU pain scales has a more important reliability than the others. Such a scale could be recommended to be used to measure pain intensity in ICU patients not able to communicate.

Detailed Description
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The aims of this observational study are to measure and compare the psychometric properties of Behavioral Pain Scale (BPS), Critical Care Pain Observation Tool (CPOT) and Non Verbal Pain Scale (NVPS) at baseline and following repositioning procedure in the ICU

Official Title
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Pain Assessment in the Intensive Care Unit

Conditions
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Delirium, Critical Illness

Intervention / Treatment
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* Procedure: Repositioning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 18 years not comatose, defined by a Richmond Agitation Sedation Scale (RASS) ≥ -3, i.e. between -3 and +4 not able to self-report accurately their pain intensity using a visually enlarged 0-10 numeric rating scale Exclusion Criteria: -neurological deficits (acute or chronic) that prevent observation of the muscle tonus or movement. For example: Quadriplegia Current use of Neuromuscular blocking agents Severe brain injuries

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pain Observations<br>Adult ICU patients who are not comatose with Richmond Agitation-Sedation Scale (RASS) score of -3 to 4 and unable to self-report pain. Patients will be excluded for neurological deficits (acute or chronic) that prevent observation of the muscle tonus or movement | Procedure: Repositioning<br>* pain assessment at baseline then following routine care repositioning in bed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain score reliability | Behavioral Pain Scale(BPS), Critical Care Pain Observation Tool (CPOT), Non Verbal Pain Scale (NVPS) | change from time 0 pain assessment to time 30min pain assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain score validity | Behavioral Pain Scale(BPS), Critical Care Pain Observation Tool (CPOT), Non Verbal Pain Scale (NVPS) | change from time 0 pain assessment to time 30min pain assessment |