Cover image of the article: Effect of pain control algorithm on pain intensity and duration of patients’ connection to the ventilator

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Effect of pain control algorithm on pain intensity and duration of patients’ connection to the ventilator

Authors

zahra karimi, Shahram MolavynejadShahram Molavynejad ORCID,*, Simin Jahani, Mahbubeh Rashidi, Amal Saki Malehi
*Corresponding Author: Email: shahrambaraz@ajums.ac.ir

Koomesh:Vol. 23, issue 5; 574-581
Published online:Dec 02, 2021
Article type:Research Article
Received:Apr 01, 2020
Accepted:Apr 02, 2021
How to Cite:karimi Z, Molavynejad S, Jahani S, Rashidi M, Saki Malehi A. Effect of pain control algorithm on pain intensity and duration of patients’ connection to the ventilator. koomesh. 2021;23(5):e153289. doi:

Abstract

Introduction: Patients undergoing mechanical ventilation cannot self-report pain because of intubation, altered levels of consciousness, and high doses of sedative agents. Therefore, inadequate pain management increases the duration of connection to the ventilator. The aim of this study was to evaluate the effect of pain control algorithm on pain intensity and duration of patients;#39 connection to ventilator. Materials and Methods: This clinical trial was conducted on 396 patients undergoing mechanical ventilation conveniently recruited from intensive care units of teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences (Ahvaz, Iran) from August 2017 to June 2016. Participants were allocated to the intervention (n=198) and control (n=198) groups through permuted block randomization. Block size was four. In the experimental group, pain intensity was measured daily for 10 days using pain behavioral instrument and pain relief was performed based on pain control algorithm. In addition, the two groups were examined daily by a researcher-made checklist for weaning criteria from the ventilator for 10 days. Results: In the experimental group, pain intensity started to decrease from the first day of intervention (P

Highlights

References

  • 1.
    Olsen BF, Rusten T, Valeberg BT. Nurse's evaluation of a pain management algorithm in intensive care units. Pain Manag Nurs 2020; 21: 543-548.
  • 2.
    Modanloo M, Mohsenpour A, Rahmani H, Moghaddam S, Khoddam H. Impact of implementing the critical care pain observation tool on nurses' performance in assessing and managing pain in the critically Ill patients. Indian J Crit Care Med 2019; 23: 165-169.
  • 3.
    Glinas C. Pain assessment in the critically ill adult: Recent evidence and new trends. Intensive Crit Care Nurs 2016; 34: 1-11.
  • 4.
    Liu Y, Li L, Herr K. Evaluation of two observational pain assessment tools in Chinese critically Ill patients. Pain Med 2015; 16: 1622-1628.
  • 5.
    Severgnini P, Pelosi P, Contino E, Serafinelli E, Novario R, Chiaranda M. Accuracy of critical care pain observation tool and behavioral pain scale to assess pain in critically ill conscious and unconscious patients: prospective, observational study. J Intensive Care 2016; 4: 68.
  • 6.
    Dehghani H, Tavangar H, Ghandehari A. Validity and reliability of behavioral pain scale in patients with low level of consciousness due to head trauma hospitalized in intensive care unit. Arch Trauma Res 2014; 3: e18608.
  • 7.
    Jeitziner MM, Schwendimann R, Hamers JP, Rohrer O, Hantikainen V, Jakob SM. Assessment of pain in sedated and mechanically ventilated patients: an observational study. Acta Anaesthesiol Scand 2012; 56: 645-654.
  • 8.
    Olsen BF, Rustoen T, Sandvik L, Miaskowski C, Jacobsen M, Valeberg BT. Development of a pain management algorithm for intensive care units. Heart Lung 2015; 44: 521-527.
  • 9.
    Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 2009; 111: 1308-1316.
  • 10.
    Bouajram RH, Sebat CM, Love D, Louie EL, Wilson MD, Duby JJ. Comparison of self-reported and behavioral pain assessment tools in critically Ill patients. J Intensive Care Med 2018; 885066618757450.
  • 11.
    Kotfis K, Zegan-Baranska M, Szydlowski L, Zukowski M, Ely EW. Methods of pain assessment in adult intensive care unit patients - Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale). Anaesthesiol Intensive Ther 2017; 49: 66-72.
  • 12.
    Boitor M, Fiola JL, Glinas C. Validation of the critical-care pain observation tool and vital signs in relation to the sensory and affective components of pain during mediastinal tube removal in postoperative cardiac surgery intensive care unit adults. J Cardiovasc Nurs 2016; 31: 425-432.
  • 13.
    Cheng LH, Tsai YF, Wang CH, Tsay PK. Validation of two Chinese-version pain observation tools in conscious and unconscious critically ill patients. Intensive Crit Care Nurs 2018; 44: 115-122.
  • 14.
    Olsen BF, Rustoen T, Sandvik L, Miaskowski C, Jacobsen M, Valeberg BT. Implementation of a pain management algorithm in intensive care units and evaluation of nurses' level of adherence with the algorithm. Heart Lung 2015; 44: 528-533.
  • 15.
    Rafiei H, Ahmadinejad M, Amiri M, Abdar esmaeili M. Effect of nursing implemented sedation and pain protocol on the level of sedation, pain and amount of sedative and analgesic drugs use among opium addicted critically ill patients. Asian J Nurs Educ Res 2013; 3: 37-41.
  • 16.
    Babamohamadi H, Tangestani F, Soleimani M, Abbasi Dorche S. Effect of a sedation guideline on the duration of mechanical ventilation and length of stay in intensive care unit. Koomesh 2017; 19: 380-390 (Persian).
  • 17.
    Woien H, Stubhaug A, Bjork IT. Analgesia and sedation of mechanically ventilated patients - a national survey of clinical practice. Acta Anaesth Scand 2012; 56: 23-29.
  • 18.
    Rose L, Smith O, Gelinas C, Haslam L, Dale C, Luk E, et al. Critical care nurses' pain assessment and management practices: a survey in Canada. Am J Crit Care 2012; 21: 251-259.
  • 19.
    Ayasrah S. Care-related pain in critically ill mechanically ventilated patients. Anaesth Intensive Care 2016; 44: 458-465.
  • 20.
    Heidarzadeh M, Chookalayi H, Jabraeelzadeh S, Kohi F. Translation and psychometrics of the "behavioral pain scale " in mechanically ventilated patients in medical and surgical intensive care units. Nurs Midwifery J 2017; 15: 176-186 (Persian).
  • 21.
    Ward D, Fulbrook P. Nursing strategies for effective weaning of the critically Ill mechanically ventilated patient. Crit Care Nurs Clin North Am 2016; 28: 499-512.
  • 22.
    Altinbas A, Canakci E. Pain management in critical patient. Arch Clin Biomed Res 2017; 1: 242-249.
  • 23.
    Rumpke AL, Zimmerman BA. Implementation of a multidisciplinary ventilator-weaning and sedation protocol in a community intensive care unit. Dimens Crit Care Nurs 2010; 29: 40-49; quiz 50-1.
  • 24.
    Olsen BF, Rustoen T, Sandvik L, Jacobsen M, Valeberg BT. Results of implementing a pain management algorithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of ventilation. J Crit Care 2016; 36: 207-211.
  • 25.
    Mansouri P, Javadpour S, Zand F, Ghodsbin F, Sabetian G, Masjedi M. Implementation of a protocol for integrated management of pain, agitation, and delirium can improve clinical outcomes in the intensive care unit: a randomized clinical trial. J Crit Care 2013; 28: 918-922.
  • 26.
    Arbour CBS, Gelinas C, Michaud C. Impact of the implementation of the critical-care pain observation tool (CPOT) on pain management and clinical outcomes in mechanically ventilated trauma intensive care unit patients: a pilot study. J Trauma Nurs 2011; 18: 52-60.
  • 27.
    Williams TA, Martin S, Leslie G, Thomas L, Leen T, Tamaliunas S, et al. Duration of mechanical ventilation in an adult intensive care unit after introduction of sedation and pain scales. Am J Crit Care 2008; 17: 349-356.
  • 28.
    Gelinas C, Arbour C, Michaud C, Vaillant F, Desjardins S. Implementation of the critical-care pain observation tool on pain assessment/management nursing practices in an intensive care unit with nonverbal critically ill adults: a before and after study. Int J Nurs Stud 2011; 48: 1495-1504.
  • 29.
    Puntillo KA, Smith D, Arai S, Stotts N. Critical care nurses provide their perspectives of patients' symptoms in intensive care units. Heart Lung 2008; 37: 466-475.##.

Copyright

© 2021, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.

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