The assessment of pain in sedated patients in intensive care units – An Integrative Literature Review (Atena Editora)

Abstract

Introduction: Patients in Intensive Care Units (ICU) experience pain during hospitalization, and factors such as sedation influence communication, preventing patients from reporting their pain. Pain causes stress and changes in the nervous system; therefore, better pain control is associated with a better and faster recovery for the person, reducing the length of hospital stay and associated costs. Nurses must resort to hetero-assessment to carry out pain assessment and monitoring, and the use of behavioral scales is advisable. Objectives: To analyze the effectiveness of the Behavior Pain Scale (BPS) and Critical Care Pain Observation Tool (CPOT) in assessing pain in sedated patients in the ICU; identify which procedures are most painful for sedated patients in the ICU. Methodology: Integrative Literature Review, based on primary, quantitative, and observational studies, acquired through the search engines EBSCOhost, B-On and the Academic Search Complete, CINAHL Complete, MedicLatina, and Medline Complete databases. We used the PICOD method to conduct the research, selecting six articles published between 2018 and 2023. Results: The articles analyzed show that the BPS and CPOT are valid and reliable scales for assessing pain in sedated patients. Both demonstrated sensitivity and reliability, allowing us to infer their pain intensity. Many routine procedures cause pain to the person. Conclusion: Both scales demonstrated adequate psychometric parameters to assess pain. Both scales are recommended simultaneously, providing a more rigorous and precise assessment of pain. There are nursing procedures that cause pain to the person, even under sedation and analgesia, such as alternating positions, respiratory rehabilitation, oral hygiene, and aspiration of secretions. The scales proved to be suitable for assessing the existence of pain in these people.