Pain assessment of traumatic brain injury victims using the Brazilian version of the Behavioral Pain Scale

Ribeiro, Caíque Jordan Nunes; Araújo, Andra Carla Santos de; Brito, Saulo Barreto; Dantas, Daniele Vieira; Nunes, Mariangela da Silva; Alves, José Antônio Barreto; Ribeiro, María do Carmo de Oliveira

doi:10.5935/0103-507x.20180009

Cited by 11 publications

(12 citation statements)

References 39 publications

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“…In their study, several reactions including eye-opening and no resistance to non-active non-vocal movement during both painful and nonpainful stimulation procedures were observed equally (10). Moreover, the behaviors in rest condition did not change in response to non-painful procedure and during NIBP, as Lee et al reported (27). As numerous tools including pain behavioral assessment tool (PBAT), pain behavioral tool( PBS), and critical pain observation tool (CPOT) which is one of the most straightforward methods (13) and use in this study , the inconsistency between their results and our study can be attributed to the instruments and tools used in the detection of behavioral responses.…”

Section: Discussionmentioning

confidence: 75%

“…It should be noted that although behavioral responses proved to increase signi cantly as a result of both painful and non-painful stimuli, the scores of behavioral responses doubled during a painful stimulus comparing before it had been used. Le et al declared that TBI patients showed more responses following the change in position or during NIBP (27). Moreover, a study by Joffe et al demonstrated that CPOT scores were considerably increased when patients were moved compared to the time when they were gently touched (28).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Vital Signs’ Fluctuations and Behavioral Responses in the Assessment of Pain in Patients With Traumatic Brain Injury

Khanghah¹,

Paryad²,

safati³

et al. 2020

Preprint

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BackgroundTraumatic brain-injured (TBI) patients suffer severe pain. The assessment of behavioral responses and vital signs seems to be necessary for pain detection in these patients, a matter that this study aims to evaluate.MethodsThis cross sectional study uses repeated measures and included ninety-seven TBI patients from Poorsina hospital, Rasht, Iran. Patients’ relevant parameters were recorded using demographic checklist, specifications related to the disease, RASS, CPOT, and FPT tools. The data subsequently were entered into SPSS software V. 21 and were analyze using several tests including Bonferroni’s inferential test and Greenhouse-Geisser test, multiple analysis regression coefficient and general linear model by GEE method.ResultsThe average age of patients was 42.3 ± 18.2. The average consciousness level was 9.30 ± 2.96. There was significant difference between the painful and non-painful stimulations in heart rate, systolic blood pressure and diastolic blood pressure (p <0.001). Heart rate (p < 0.001, r = 0.253), number of respiration (p < 0.001, r = 0.173), systolic (p = 0.002, r = 0.128) and diastolic (p<0.001, r=0.223) blood pressures had a positive correlation with behavioral responses. However, the arterial oxygen saturation showed a negative correlation with behavioral responses (p < 0.001, r = -0.361). Statistical models demonstrated a significant direct relationship between CPOT with heart rate (β = 2.39, p < 0.001) and both systolic blood pressure (β= 1.31, p=0.002) and the fluctuations of diastolic blood pressure (β = 0.690, p = 0.009). ConclusionIt seems that behavioral responses are appropriate indices for pain detection. However, vital signs are not capable of being considered as proper indexes for pain assessment since they changed during several procedures while remained unchanged in other tests.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Evaluation of Vital Signs’ Fluctuations and Behavioral Responses in the Assessment of Pain in Patients With Traumatic Brain Injury

Khanghah¹,

Paryad²,

safati³

et al. 2020

Preprint

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“…Research, Society and Development, v. 10, n. 6, e52610616181, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i6.16181 diseases (Ribeiro et al, 2018). Thus, the significant carryover effect observed in the parameters of DBP and SpO2 do not invalidate the interpretation of the analgesic effectiveness of music during LRP.…”

Section: Discussionmentioning

confidence: 96%

Efeito analgésico da música durante a fotocoagulação retinal a laser em diabéticos: Um estudo cruzado, randomizado e controlado por placebo

Ribeiro¹,

Ribeiro²,

Oliveira³

et al. 2021

RSD

Self Cite

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Objetivo: Avaliar prospectivamente o efeito analgésico da música de preferência do paciente com retinopatia diabética que foram submetidos à fotocoagaluação retiniana a laser (FRL). Metodologia: Trata-se de um ensaio clínico controlado, randomizado, cego e crossover de dois períodos. Participaram vinte pacientes (40 olhos) com retinopatia diabética proliferativa que foram submetidos à FRL. A escuta musical de preferência do paciente antes e durante a FRL foi a intervenção não farmacológica testada. O grupo controle (GC) foi composto por pacientes que receberam apenas o tratamento farmacológico padrão e o grupo experimental (GE) por aqueles que receberam a intervenção associada ao tratamento farmacológico padrão. A dor foi mensurada pela Escala Numérica Verbal. As diferenças dos escores de dor foram examinadas por meio dos testes Aligned Rank Transformed ANOVA, Mann-Whitney U e de Wilcoxon. O tamanho do efeito das diferenças foi avaliado usando Tamanhos de Efeito Rank Bisserial e Parcial Square. Resultados: Os participantes eram predominantemente do sexo masculino (60%), adultos (57,4±9,1 anos), com comorbidades (65%), com deficiência visual ≥ 1 ano (65%). Os participantes que ouviram música apresentaram menores escores de dor (GE: 4,80±2,46) comparados aos que não ouviram (GC:6,75±1,59; p=0,013). A aplicação de música de preferência do paciente mostrou um grande tamanho do efeito analgésico (η²=0,189). Conclusão: Ouvir música de preferência do paciente, associada à analgesia padrão, é eficaz no alívio da dor aguda relacionada à FRL e deve ser incorporada à prática clínica para o tratamento multimodal da dor nesse procedimento.

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“…Behaviors not included in original versions of the scales such as orbit tightening, eye weeping (tearing), and face flushing were described in this patient population [ 17 – 19 ]. Low levels of consciousness (LOC) or high sedation levels, often present in brain-injured ICU patients, were associated with low frequency of behaviors indicative of pain [ 17 – 19 ] and low behavioral scale scores [ 8 , 9 , 12 , 20 ]. Adaptation of the content of existing scales for brain-injured ICU patients could enhance their applicability and ability to accurately detect pain in this vulnerable population.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Critical-Care Pain Observation Tool-Neuro in brain-injured adults in the intensive care unit: a prospective cohort study

et al. 2021

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Background Pain assessment in brain-injured patients in the intensive care unit (ICU) is challenging and existing scales may not be representative of behavioral reactions expressed by this specific group. This study aimed to validate the French-Canadian and English revised versions of the Critical-Care Pain Observation Tool (CPOT-Neuro) for brain-injured ICU patients. Methods A prospective cohort study was conducted in three Canadian and one American sites. Patients with a traumatic or a non-traumatic brain injury were assessed with the CPOT-Neuro by trained raters (i.e., research staff and ICU nurses) before, during, and after nociceptive procedures (i.e., turning and other) and non-nociceptive procedures (i.e., non-invasive blood pressure, soft touch). Patients who were conscious and delirium-free were asked to provide their self-report of pain intensity (0–10). A first data set was completed for all participants (n = 226), and a second data set (n = 87) was obtained when a change in the level of consciousness (LOC) was observed after study enrollment. Three LOC groups were included: (a) unconscious (Glasgow Coma Scale or GCS 4–8); (b) altered LOC (GCS 9–12); and (c) conscious (GCS 13–15). Results Higher CPOT-Neuro scores were found during nociceptive procedures compared to rest and non-nociceptive procedures in both data sets (p < 0.001). CPOT-Neuro scores were not different across LOC groups. Moderate correlations between CPOT-Neuro and self-reported pain intensity scores were found at rest and during nociceptive procedures (Spearman rho > 0.40 and > 0.60, respectively). CPOT-Neuro cut-off scores ≥ 2 and ≥ 3 were found to adequately classify mild to severe self-reported pain ≥ 1 and moderate to severe self-reported pain ≥ 5, respectively. Interrater reliability of raters’ CPOT-Neuro scores was supported with intraclass correlation coefficients > 0.69. Conclusions The CPOT-Neuro was found to be valid in this multi-site sample of brain-injured ICU patients at various LOC. Implementation studies are necessary to evaluate the tool’s performance in clinical practice.

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Pain assessment of traumatic brain injury victims using the Brazilian version of the Behavioral Pain Scale

Cited by 11 publications

References 39 publications

Evaluation of Vital Signs’ Fluctuations and Behavioral Responses in the Assessment of Pain in Patients With Traumatic Brain Injury

Evaluation of Vital Signs’ Fluctuations and Behavioral Responses in the Assessment of Pain in Patients With Traumatic Brain Injury

Efeito analgésico da música durante a fotocoagulação retinal a laser em diabéticos: Um estudo cruzado, randomizado e controlado por placebo

Validation of the Critical-Care Pain Observation Tool-Neuro in brain-injured adults in the intensive care unit: a prospective cohort study

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