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Updated: May 11, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
[Pain perception in the vegetative state: current status and critical reflections]
1Ecole des sciences infirmières Ingram, Université McGill, Montréal, Québec, Canada. caroline.arbour@mail.mcgill.ca
Vegetative state (VS) patients may show reflexes to painful stimuli, but lack voluntary reactions. Neuroimaging can reveal hidden consciousness, prompting prophylactic pain treatment in VS patients.
Area of Science:
- Neuroscience
- Clinical Medicine
- Pain Management
Context:
- Vegetative state (VS) patients are presumed unable to perceive pain, yet many nurses believe otherwise.
- Assessing pain perception in VS patients is challenging due to subjective behavioral responses.
- The role of associative brain areas in pain perception remains unclear.
Purpose:
- To identify criteria for detecting pain perception in vegetative state (VS) patients.
- To review clinical and research practices for assessing pain in VS patients.
- To explore objective markers of pain consciousness in VS patients.
Summary:
- An integrative review analyzed 4 clinical articles and 7 empirical studies on pain perception in VS patients.
- Reflexes like fist clenching may occur with stimuli, but voluntary reactions indicate altered diagnosis.
- Functional neuroimaging (fMRI, PET) can detect brain activation, revealing objective signs of consciousness.
Impact:
- Neuroimaging offers objective insights into pain perception in VS patients, complementing bedside assessments.
- Findings highlight the complexity and subjectivity of behavioral assessments in VS patients.
- Experts recommend prophylactic pain management due to the incomplete understanding of pain perception in VS patients.
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