The Pain in Intensive Care Unit: Different Rating System Comparing

The Pain in Intensive Care Unit: An Experimental Research to Compare Behavioural Pain Scale (BPS) and Critical Care Pain Observation Tool (CPOT)

The purpose of this research is to find the best system for assessing the pain of critically ill patient in Intensive Care Unit (ICU).

At first the investigators assess the sedation of the patient with the scale sedation-agitation scale (SAS) or the delirium with the confusion assessment method, if the patient is too sedated or delirious the investigators consider him unable to use the Visual Analogic Scale (VAS).

The investigators compare two different scales Critical Care Pain Observation Tool (CPOT) and Behavioural Pain Scale (BPS) which include no verbal items. Each items has been evaluated in three different moments: before, during and after the nurses' care.

The investigators compare the scales between them. Then, every time the investigators value the score of these scales with the self-report of patients with the VAS scale (when it is possible) and finally with the physiological parameters (blood pressure, heart rate and respiratory rate).

In the end, the investigators compare two different classes of patient: the surgical and medical one. The investigators search for some differences in the perception of the pain between these two classes.

This study has specific aims:

1. to find the best method to evaluate the pain in critically ill patients;
2. to compare the perception of pain analysed trough CPOT and BPS;
3. to compare CPOT and BPS between medical and surgical patients.

Inclusion Criteria:

• male and female
• require of Mechanical Ventilation (MV)
• Hospitalization on ICU > 24 hours

Exclusion Criteria:

• Age < 18 years
• Tetraplegic
• Neuromuscolar disease
• Neuromuscolar blocking agents by continuous infusion
• Spontaneous breathing without Mechanical Ventilation (MV)