Pain Assessment Is Associated with Decreased Duration of Mechanical Ventilation in the Intensive Care Unit

Payen, Jean François; Bosson, Jean Luc; Chanques, Gérald; Mantz, Jean; Labarère, José

doi:10.1097/aln.0b013e3181c0d4f0

Cited by 302 publications

(212 citation statements)

References 55 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…A ‘0–3’ score was most frequently employed, and it is unclear what this score represented; it might have been an observed version of a self‐report measure, the verbal rating scale (VRS) 24, a tool that has not been validated for use in critical care. The lack of adherence to the ACCM guidelines is concerning, as regular, validated pain assessment has consistently been associated with improved patient outcomes 6, 8.…”

Section: Discussionmentioning

confidence: 99%

“…Failure to conduct appropriate pain assessment hinders adequate pain management, and pain can lead to deleterious acute and chronic physiological and psychological consequences 5. Simply assessing pain can improve patient satisfaction and clinical outcomes, including: number of ‘ventilator days’; length of intensive care stay; and survival 2, 6, 7. This is thought to be due to increased prioritisation of pain and more frequent alterations to analgesic prescriptions 2.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pain Assessment in INTensive care (PAINT): an observational study of physician‐documented pain assessment in 45 intensive care units in the United Kingdom

et al. 2017

View full text Add to dashboard Cite

SummaryPain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia‐related entries in patients’ records over a 24‐h period, in 45 adult intensive care units (ICUs) in London and the South‐East of England. Data were collected from 750 patients, reflecting the practice of 362 physicians. Nearly two‐thirds of patients (n = 475, 64.5%, 95%CI 60.9–67.8%) received no physician‐documented pain assessment during the 24‐h study period. Just under one‐third (n = 215, 28.6%, 95%CI 25.5–32.0%) received no nursing‐documented pain assessment, and over one‐fifth (n = 159, 21.2%, 95%CI 19.2–23.4)% received neither a doctor nor a nursing pain assessment. Two of the 45 ICUs used validated behavioural pain assessment tools. The likelihood of receiving a physician pain assessment was affected by the following factors: the number of nursing assessments performed; whether the patient was admitted as a surgical patient; the presence of tracheal tube or tracheostomy; and the length of stay in ICU. Physician‐documented pain assessments in the majority of participating ICUs were infrequent and did not utilise recommended behavioural pain assessment tools. Further research to identify factors influencing physician pain assessment behaviour in ICU, such as human factors or cultural attitudes, is urgently needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain Assessment in INTensive care (PAINT): an observational study of physician‐documented pain assessment in 45 intensive care units in the United Kingdom

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Pain assessment in mechanically ventilated patients is independently associated with a reduction in the duration of ventilator support and duration of intensive care unit (ICU) stay [2]. Inadequate analgesia causes serious long-term psychological complications and has several known pathophysiological consequences [3,4].…”

Section: Introductionmentioning

confidence: 99%

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

et al. 2010

View full text Add to dashboard Cite

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients Abstract Purpose: To compare the quality of analgesia provided by a remifentanil-based analgesia regime with that provided by a fentanylbased regime in critically ill patients. Methods: This was a registered, prospective, two-center, randomized, triple-blind study involving adult medical and surgical patients requiring mechanical ventilation (MV) for more than 24 h. Patients were randomized to either remifentanil infusion or a fentanyl infusion for a maximum of 30 days. Sedation was provided using propofol (and/or midazolam if required). Results: Primary outcome was the proportion of patients in each group maintaining a target analgesia score at all time points. Secondary outcomes included duration of MV, discharge times, and morbidity. At planned interim analysis (n = 60), 50% of remifentanil patients (n = 28) and 63% of fentanyl patients (n = 32) had maintained target analgesia scores at all time points (p = 0.44). There were no significant differences between the groups with respect to mean duration of ventilation (135 vs. 165 h, p = 0.80), duration of hospital stay, morbidity, or weaning. Interim analysis strongly suggested futility and the trial was stopped. Conclusions: The use of remifentanil-based analgesia in critically ill patients was not superior regarding the achievement and maintenance of sufficient analgesia compared with fentanyl-based analgesia.

show abstract

“…Systematic pain assessment, with either patient self-reporting or use of behavioral pain assessment tools as appropriate, can improve patients' outcomes. In a large multicenter observational study, 12 pain assessment was associated with reductions in the duration of mechanical ventilation and ICU stay. In a small study 13 involving patients in a neurotrauma ICU, introduction of the Nonverbal Pain Scale 9 increased documentation of pain assessments and decreased recalled severity of the pain patients experienced.…”

mentioning

confidence: 99%

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Rose¹,

Haslam²,

Dale³

et al. 2013

American Journal of Critical Care

View full text Add to dashboard Cite

Pain Assessment Is Associated with Decreased Duration of Mechanical Ventilation in the Intensive Care Unit

Cited by 302 publications

References 55 publications

Pain Assessment in INTensive care (PAINT): an observational study of physician‐documented pain assessment in 45 intensive care units in the United Kingdom

Pain Assessment in INTensive care (PAINT): an observational study of physician‐documented pain assessment in 45 intensive care units in the United Kingdom

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Contact Info

Product

Resources

About