The Effects of a Systematic Pain Assessment Approach on Critically Ill Patients Outcomes in ICU

Cyprus University of Technology120 enrolled

Overview

The purpose of this study is to investigate the effectiveness of a systematic approach to pain assessment in the critically ill patients' outcome The investigators hypothesize that, patients who will undergo systematic pain assessment and they will have their results notified to physicians and nurses, will demonstrate favorable effects on pain intensity, more efficient use of sedatives and analgesics, duration of mechanical ventilation, length of ICU stay, mortality, adverse events and complications, in relation to patients who will receive standard care alone. Moreover it is expected that they will demonstrate altered levels of plasma neuropeptides and biochemical markers in peripheral blood.

Appropriate pain management depends on the systematic and comprehensive assessment of pain. Inaccurate pain assessment and the resulting inadequate treatment of pain in critically ill adults can have significant physiological and psychological consequences. The investigators will examine whether a systematic pain assessment approach can improve patients outcomes. 120 ICU patients will be randomized either to control or intervention group. The control group will receive standard care plus pain assessments but nurses and physicians will be blind of these results. The intervention group will receive standard care plus systematic pain assessment and the results will be notified to nurses and physicians.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

120

Conditions

Pain

Interventions

Systematic pain assessmentOTHER

Systematic assessment of pain twice daily with the use of 2 different behavioral pain tools (Behavioral Pain Scale - BPS, and Critical Care Pain Observation Tool - C-POT) for non-communicative patients and Numerical Rating Scale (NRS) 1-10 for communicative patients.

Notification of results of assessmentsOTHER

Pain assessments will be carried out by independent investigators who will notify the results to ICU nurses and physicians and observe and document their reaction

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18 years and older * All patients with an estimated source of pain or due to immunological process as trauma, surgery, or due to general factors such as endotracheal intubation, interventional catheters Exclusion Criteria: * Length of stay in the ICU \<24 hours * The patient receives neuromuscular blockers, * The patient has a disease or condition, such as Guillain-Barre, peripheral neuropathy, which modifies sensory transmission of painful stimuli * The patient has a disease or condition which complicates the assessment of pain behavior, such as decerebration or vegetative state, agitation\> 3 in the Richmond Agitation sedation Scale (RASS)

Locations (1)

Nicosia General Hospital

Nicosia, Cyprus

RECRUITING

Outcomes

Primary Outcomes

a) Level of pain (intensity, incidence of high levels of pain with a numerical pain scale NRS> 6, Behavioral pain scale (BPS) > 5 and Critical pain observation Tool (C-POT) >2

Time frame: morning between 9:00-11: hrs, and afternoon between 4:00-6:00 hrs) for ten continuous days

To investigate the effect of the systematic assessment of pain among patients groups - control and intervention as to:The total dose, frequency of administration and the type of analgesics and sedatives received

Time frame: every 24 hrs for ten continuous days

Secondary Outcomes

Effect of the systematic evaluation of pain among patients groups - control and intervention as to:The degree of sedation/agitation

Time frame: morning between 9:00-11: hrs, and afternoon between 4:00-6:00 hrs) for ten continuous days

Effect of the systematic evaluation of pain among patients groups - control and intervention as to:The levels of biochemical marker, cortisol, in the serum