Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190021
Brazilian Journal of Pain
Original Article

Pain assessment in critical patients using the Behavioral Pain Scale

Avaliação da dor em pacientes críticos por meio da Escala Comportamental de Dor

Laudice Santos Oliveira; Maiara Pimentel Macedo; Stefany Ariadley Martins da Silva; Ana Paula de Freitas Oliveira; Victor Santana Santos

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Abstract

BACKGROUND AND OBJECTIVES: The sensation of pain is essential for life, and its assessment in critical non-contacting patients can be performed using validated scales. The Behavioral Pain Scale is a highly accurate tool that has been widely used in this group of patients. This study aimed to describe and characterize pain and the use of analgesia in the emergency or intensive care service.

METHODS: This was a cross-sectional study with a quantitative approach with 67 critically ill patients unable to verbalize their pain perception, who were hospitalized in the emergency service or Intensive Care Units of a public hospital in Vitória da Conquista, Bahia from April to July 2017. Clinical and epidemiological data were collected using the medical record and then applied to the Behavioral Pain Scale for pain assessment.

RESULTS: There was a predominance of male patients (47/70.1%). Three groups were identified based on the use of sedatives and analgesics: patients taking sedatives and analgesics combined, only analgesia, and those without any sedation or analgesia. We observed ascending Behavioral Pain Scale scores in all groups during tracheal suction, but the same did not occur with the physiological parameters.

CONCLUSION: The study proposes the adoption of pain assessment scales in critical patients, such as the Behavioral Pain Scale, as well as the use of protocols for analgesia management, and consequently improve the quality of care and patient's recovery.

Keywords

Emergency medical services, Intensive Care Units, Pain, Pain management, Pain measurement

Resumo

JUSTIFICATIVA E OBJETIVOS: A sensação de dor é essencial para a vida. Sua avaliação em pacientes críticos não contatantes pode ser realizada por meio de escalas validadas. A Behavioral Pain Scale é um instrumento de aplicação, com elevada acurácia, e que tem sido amplamente utilizada neste grupo de pacientes. Este estudo objetivou descrever e caracterizar a dor e o uso de analgesia no serviço de urgência e cuidados intensivos.

MÉTODOS: Trata-se de um estudo transversal com abordagem quantitativa, realizado com 67 pacientes críticos impossibilitados de verbalizar a percepção de dor, os quais estavam hospitalizados na área vermelha do pronto-socorro ou nas Unidades de Terapia Intensiva de um hospital público de referência em Vitória da Conquista, Bahia no período de abril a julho de 2017. Dados clínicos e epidemiológicos foram coletados utilizando-se o prontuário e em seguida foi aplicada a Behavioral Pain Scale para avaliação da dor.

RESULTADOS: Houve predomínio de pacientes do sexo masculino (47/70,1%). Foram identificados três grupos com base no uso de sedativos e analgésicos: pacientes em uso de sedoanalgesia, uso apenas de analgesia, e os que estavam sem sedação ou analgesia. Visualizou-se ascensão dos escores da Behavioral Pain Scale em todos os grupos durante a aspiração traqueal, porém o mesmo não aconteceu com os parâmetros fisiológicos.

CONCLUSÃO: O estudo apresentou como proposta a adoção de escalas de avaliação da dor no paciente crítico, como a Behavioral Pain Scale, bem como uso de protocolos de analgesia e manuseio, melhorando assim a qualidade da assistência prestada e a recuperação do paciente.

Palavras-chave

Dor, Manuseio da dor, Mensuração da dor, Pronto-Socorro, Unidade de Terapia Intensiva

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Submitted date:
05/10/2018

Accepted date:
02/19/2019

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