The Pain in Intensive Care Unit: Different Rating System Comparing

Study Overview
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Brief Summary
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The purpose of this research is to find the best system for assessing the pain of critically ill patient in Intensive Care Unit (ICU). At first the investigators assess the sedation of the patient with the scale sedation-agitation scale (SAS) or the delirium with the confusion assessment method, if the patient is too sedated or delirious the investigators consider him unable to use the Visual Analogic Scale (VAS). The investigators compare two different scales Critical Care Pain Observation Tool (CPOT) and Behavioural Pain Scale (BPS) which include no verbal items. Each items has been evaluated in three different moments: before, during and after the nurses' care. The investigators compare the scales between them. Then, every time the investigators value the score of these scales with the self-report of patients with the VAS scale (when it is possible) and finally with the physiological parameters (blood pressure, heart rate and respiratory rate). In the end, the investigators compare two different classes of patient: the surgical and medical one. The investigators search for some differences in the perception of the pain between these two classes.

Detailed Description
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This study has specific aims: to find the best method to evaluate the pain in critically ill patients; to compare the perception of pain analysed trough CPOT and BPS; to compare CPOT and BPS between medical and surgical patients.

Official Title
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The Pain in Intensive Care Unit: An Experimental Research to Compare Behavioural Pain Scale (BPS) and Critical Care Pain Observation Tool (CPOT)

Conditions
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Critical Illness

Intervention / Treatment
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* Other: CPOT, BPS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: male and female require of Mechanical Ventilation (MV) Hospitalization on ICU > 24 hours Exclusion Criteria: Age < 18 years Tetraplegic Neuromuscolar disease Neuromuscolar blocking agents by continuous infusion Spontaneous breathing without Mechanical Ventilation (MV)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 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 |
| --- | --- |
| ICU patients<br>All patients admitted to ICU for a minimal hospitalization of 24 hours, invasive mechanically ventilated, will be evaluated with CPOT and BPS scores, during nurses work, in particular before and after nurses manoeuvers. | Other: CPOT, BPS<br>* Scoring pain of the patients during nurses activity in ICU, in particular before and after nurses manoeuvers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The evaluation of pain in critically ill patients | The measurement of pain with no verbal items of different pain scales: facial expression, movements of the body, muscle tone, compliance of mechanical ventilation, movements of the arms. We'll evaluate the level of pain before and after nurses manoeuvers | Participants will be followed for 3 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The comparisation beetween the CPOT and the BPS scales | The comparisation beetween the different items of two scales: CPOT (facial expression, movements of the body, muscle tone, compliance of mechanical ventilation) and BPS (facial expression, movements of the arms, compliance of mechanical ventilation). | Participants will be followed for 3 days | 
| The comparisation of CPOT and BPS between medical and surgical critically ill patients | We'll measure facial expression, movements of the body, muscle tone, compliance of mechanical ventilation, movements of the arms, according with BPS and CPOT scores in two classes of patient: the surgical and medical critically ill patients. | Participants will be followed for 3 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain, Mechanical ventilation, CPOT, BPS, ICU