Evaluation of pain in ICU patients

Kathleen Puntillo, Chris Pasero, Denise Li, Richard A. Mularski, Mary Jo Grap, Brian L. Erstad, Basil Varkey, Hugh C. Gilbert, Justine Medina, Curtis N. Sessler

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Pain is a common and distressing symptom in ICU patients. Yet a major challenge exists in assessing and evaluating the pain. Although the patient's self-report of pain is the "gold standard" for pain assessment, other methods must be considered when patients are unable to self-report. Currently only two pain behavior instruments have been tested for their reliability, validity, and feasibility of use in ICUs: the pain behavior scale and the Critical-Care Pain Observation Tool. Other tools, albeit with less validity testing, include the pain assessment, intervention, and notation (PAIN) algorithm and a pain behaviors checklist. When established tools are insufficient to evaluate a patient's pain, alternative methods of augmenting a pain evaluation should be considered. These can include the completion of a pain risk profile, use of surrogates, or performance of an analgesic trial. Meticulous attention to the evaluation of a critically ill patient's pain provides the basis for selection of pain interventions and the subsequent assessment of the intervention's effectiveness.

Original languageEnglish (US)
Pages (from-to)1069-1074
Number of pages6
JournalCHEST
Volume135
Issue number4
DOIs
StatePublished - Apr 1 2009

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Keywords

  • Icu pain
  • Pain assessment
  • Pain evaluation
  • Pain tools

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Puntillo, K., Pasero, C., Li, D., Mularski, R. A., Grap, M. J., Erstad, B. L., Varkey, B., Gilbert, H. C., Medina, J., & Sessler, C. N. (2009). Evaluation of pain in ICU patients. CHEST, 135(4), 1069-1074. https://doi.org/10.1378/chest.08-2369