Please use this identifier to cite or link to this item: https://ktisis.cut.ac.cy/handle/10488/4174
Title: Determinants of procedural pain intensity in the intensive care unit: the Europain® study
Authors: Puntillo, Kathleen A. 
Max, Adeline 
Timsit, Jean-Francois 
Vignoud, Lucile 
Chanques, Gerald 
Gemma, Robleda 
Roche-Campo, Ferran 
Mancebo, Jordi 
Divatia, Jigeeshu V. 
Soares, Marcio 
Ionescu, Daniela C. 
Grintescu, Ioana M. 
Vasiliu, Irena L. 
Maggiore, Salvatore Maurizio 
Rusinova, Katerina 
Owczuk, Radoslaw 
Egerod, Ingrid 
Papathanassoglou, Elizabeth 
Kyranou, Maria 
Joynt, Gavin M. 
Burghi, Gaston 
Freebairn, Ross C. 
Ho, Kwok 
Kaarlola, Anne 
Gerritsen, Rik T. 
Kesecioglu, Jozef 
Sulaj, Miroslav M S 
Norrenberg, Michelle 
Benoit, Dominique D. 
Seha, Myriam S. G. 
Hennein, Akram 
Periera, Fernando J. 
Benbenishty, Julie Sarah 
Abroug, Fekri 
Aquilina, Andrew 
Monte, Julia R. C. 
An, Youzhong 
Azoulay, Elie 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Symptom assessment;Analgesia;Prevention
Issue Date: 1-Jan-2014
Source: American Journal of Respiratory and Critical Care Medicine, 2014, vol. 189, no. 1, pp. 39-47
Volume: 189
Issue: 1
Start page: 39
End page: 47
Journal: American Journal of Respiratory and Critical Care Medicine 
Abstract: Rationale:Intensive care unit (ICU) patients undergo several diagnostic and therapeutic procedures every day. The prevalence, intensity, and risk factors of pain related to these procedures are not well known. Objectives: To assess self-reported procedural pain intensity versus baseline pain, examine pain intensity differences across procedures, and identify risk factors for procedural pain intensity. Methods: Prospective, cross-sectional, multicenter, multinational study of pain intensity associated with 12 procedures. Data were obtained from 3,851 patients who underwent 4,812 procedures in 192 ICUs in 28 countries. Measurements andMain Results: Painintensity on a 0–10 numeric rating scale increased significantly from baseline pain during all procedures (P , 0.001). Chest tube removal, wound drain removal, and arterial line insertion were the three most painful procedures, with median pain scores of 5 (3–7), 4.5 (2–7), and 4 (2–6), respectively. By multivariate analysis, risk factors independently associated with greater procedural pain intensity were the specific procedure; opioid administration specifically for the procedure; preprocedural pain intensity; preprocedural pain distress; intensity of the worst pain on the same day, before the procedure; and procedure not performed by a nurse. A significant ICU effect was observed, with no visible effect of country because of its absorption by the ICU effect. Some of the risk factors became nonsignificant when each procedure was examined separately. Conclusions: Knowledge of risk factors for greater procedural pain intensity identified in this study may help clinicians select interventions that are needed to minimize procedural pain. Clinical trial registered with www.clinicaltrials.gov (NCT 01070082).
URI: http://ktisis.cut.ac.cy/handle/10488/4174
ISSN: 1535-4970
DOI: 10.1164/rccm.201306-1174OC
Rights: © American Thoracic Society
Type: Article
Affiliation : Peking University People’s Hospital 
University of California 
University of Paris-Diderot 
Hopital A. Michallon 
Institut Albert Bonniot 
Hopital Saint Eloi 
University of Montpellier 
Hospital de Sant Pau 
Tata Memorial Hospital 
Instituto Nacional de Cancer 
Iuliu Hatieganu University of Medicine and Pharmacy 
Clinical Emergency Hospital 
Universidad Michoacana de San 
First Faculty of Medicine of Charles University 
Medical University of Gdansk 
Copenhagen University Hospital 
Cyprus University of Technology 
Papageorgiou General Hospital 
Prince of Wales Hospital 
Hospital Maciel 
Health Directorate/General Army Staff 
Royal Perth Hospital 
Helsinki University Hospital 
Medical Centre Leeuwarden 
University Medical Center Utrecht 
University Hospital Martin 
Erasme Hospital 
Universite Libre de Bruxelles 
Spital Maennedorf 
Khoula Hospital 
Clinica Las Americas 
Hadassah Hebrew University Medical Center 
CHU F.Bourguiba 
Mater Dei Hospital 
Hospital Santo Antonio 
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