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Pain evaluation in the intensive care unit: observer-reported faces scale compared with self-reported visual analog
1Department of Anesthesiology and Intensive Care Medicine, Osaka City University Medical School, Osaka, Japan.
Regional Anesthesia and Pain Medicine
|May 7, 1998
Summary
The faces scale shows promise for assessing pain in adult intensive care unit (ICU) patients, agreeing well with the visual analog scale (VAS) shortly after extubation.
Area of Science:
- Pain Management
- Critical Care Medicine
- Patient Monitoring
Background:
- The visual analog scale (VAS) is a standard pain assessment tool.
- The faces scale is a validated self-reporting method for pediatric pain assessment.
- Facial signs of pain have not been extensively studied in adult ICU patients post-surgery.
Purpose of the Study:
- To evaluate the utility of a five-grade faces scale for assessing postoperative pain in adult intensive care unit (ICU) patients.
- To compare the agreement between the faces scale and the visual analog scale (VAS) in this patient population.
Main Methods:
- Fifty adult patients undergoing thoracoabdominal esophageal cancer surgery were studied.
- Pain was assessed using the VAS and a five-grade faces scale by a nurse unaware of VAS scores.
- Agreement was analyzed using weighted kappa statistics at various time points post-tracheal extubation.
Main Results:
- Good agreement was observed between the faces scale and VAS within 1 hour after extubation (kappa values .67 and .62).
- Moderate agreement (kappa .54) was found across all observations, with less agreement in patients experiencing moderate pain.
- Significant differences in mean scale values were noted between patients.
Conclusions:
- The five-grade faces scale demonstrates potential as a valuable tool for pain evaluation in adult ICU patients.
- Further research may refine its application, particularly for patients with moderate pain levels.