Recommendations of the Polish Association of Anaesthesia and Intensive Care Nurses on pain monitoring in Intensive Care Units using a Polish version of the behavioural Pain Scale (bPS)

Introduction. In 2018, another update of the Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/ Sedation, Delirium, Immobilization and Sleep Disorders in Adult Patients Treated in Intensive Care Units (ICUs) was released. Aim. The study is aimed at presenting current recommendations concerning pain management in patients treated in ICU, and presenting the algorithm of pain assessment and monitoring in patients treated in ICU, using a Polish version of the BPS (Behavioural Pain Scale). The guidelines were prepared based on a systematic review of the literature published in the years 2013-2018. Material and methods. The search for scientific publications was carried out using electronic databases in English and Polish. The following keywords and their combinations were used in the searches: pain, assessment, monitoring, nurse, intensive care, adult patient, unable to communicate. Initially, 758 papers were identified with the use of keywords. After excluding duplicates and preliminary checking and selecting the titles of publications and abstracts, 85 papers were qualified for the analysis of full text. Conclusions. Access to effective pain treatment is a fundamental human right. Recommendations of the Polish Association of Anaesthesia and Intensive Care Nurses, concerning pain monitoring in ICU using a Polish version of the Behavioural Pain Scale (BPS), developed by the Task Force for Practice, are intended to provide a specific guideline for developing effective local pain management strategies in ICU.

Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries

Study Objective: The use of an easy to apply reliable tool is essential to assess pain in patients in intensive care units. This study aimed primarily to evaluate perfusion index usefulness as an objective indicator of pain. Methods and Measurements: Data were collected from 40 non-intubated adult patients admitted to the surgical intensive care unit postoperatively. The Masimo pulse co-oximetry perfusion index (PI) probe was attached to the patient. At the time of the first request for analgesia (T1), the Behavioural pain scale non-intubated scoring system (BPS-NI) was recorded with the PI and patients' haemodynamics following which rescue analgesia was given. Thirty minutes thereafter (T2), second measurements for the mentioned parameters were taken. Main Results: There was a statistically significant reduction in the BPS-NI score, blood pressure and heart rate after analgesic administration (P-values, <0.001, 0.039 and 0.001, respectively), together with a significant increase in the PI (P-value, 0.004). This means that the PI increases with adequate relief from pain, as indicated by a decrease in BPS-NI score and haemodynamics, but the correlation was not statistically significant between their changes. Conclusion: There was no statistically significant correlation between the PI and the pain score or other clinical indicators of pain either before or after the administration of analgesic.