| BPS |
Payen
et al.44 Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29(12):2258-63.
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Consistência interna moderada a boa22 Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abid K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg. 2005;101(5):1470-6.,99 Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioral Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs. 2006 Feb;22(1):32-9.,1414 Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg. 2010;110(1):127-33., concordância entre avaliadores moderada a quase perfeita44 Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29(12):2258-63.,99 Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioral Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs. 2006 Feb;22(1):32-9.,1414 Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg. 2010;110(1):127-33.. Não foi encontrada correlação significativa entre a escala e variáveis fisiológicas22 Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abid K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg. 2005;101(5):1470-6.. |
| CPOT |
Gélinas
et al.55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.
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Propriedades discriminantes moderadas a boas; boa consistência interna11 Marmo L, Fowler S. Pain assessment tool in the critically ill post-open heart surgery patient population. Pain Manag Nurs. 2010;11(3):134-40.,2020 Paulson-Conger M, Leske J, Maidl C, Hanson A, Dziadulewicz L. Comparison of two pain assessment tools in nonverbal critical care patients. Pain Manag Nurs. 2011;12(4):218-24.; regular a quase perfeita concordância entre avaliadores11 Marmo L, Fowler S. Pain assessment tool in the critically ill post-open heart surgery patient population. Pain Manag Nurs. 2010;11(3):134-40.,55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.,1919 Keane KM. Validity and reliability of the critical care pain observation tool: a replication study. Pain Manag Nurs. 2013;14(4):e216-e25.; durante o estímulo doloroso apresentou sensibilidade 66,7-86%, especificidade 78-83,3% e acurácia 63%1717 Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston C. Sensitivity and specificity of the Critical-Care Pain Observation Tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage. 2009;37(1):58-67.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.; correlação significativa entre o autorrelato de dor e o escore do CPOT durante o procedimento doloroso55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.. A definição do valor de corte durante procedimento doloroso variou entre >2 e >31717 Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston C. Sensitivity and specificity of the Critical-Care Pain Observation Tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage. 2009;37(1):58-67.,1818 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505.. Maiores escores do CPOT durante e imediatamente após procedimento doloroso55 Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006;15(4):420-7.,1616 Lee K, Oh H, Suh Y, Seo W. Patterns and clinical correlates of pain among brain injury patients in critical care assessed with the Critical Care Pain Observation Tool. Pain Manag Nurs. 2013;14(4):259-67.. Após implementação do instrumento, ocorrência de maior frequência de reavaliação da dor, de episódios de dor e menor número de complicações1515 Arbour C, Gélinas C, Michaud C. Impact of the implementation of the Critical Care Pain Observation Tool (CPOT) on pain management and clinical outcomes in mechanically ventilated trauma intensive care unit patients: a pilot study. J Trauma Nurs. 2011;18(1):52-60.. |
| NCS / NCS-R |
Schnakers et al.77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9. / Chatelle et al.88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.
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Encontrada diferença significativa entre os diagnósticos de estado vegetativo e estado de mínima consciência77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9.,88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.. Através da análise de curva de ROC, foram definidos os seguintes valores de corte para a NCS: <2 nenhuma dor, 2-3 possível presença de dor, e ≥3 provável presença de dor. Os valores de corte para a NCS-R foram: <1 sem dor, 1-2 possível presença de dor, e ≥2 provável presença de dor. NCS: moderada a boa concordância entre avaliadores77 Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain. 2010;148(2):215-9.,2121 Riganello F, Cortese MD, Arcuri F, Candelieri A, Guglielmino F, Dolce G, et al. A study of reliability of the Nociception Coma Scale. Clin Rehabil. 2015;29(4):388-93.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.; sensibilidade 46-73,6%, especificidade 67,3-97% e acurácia 72%88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.. NCS-R: boa concordância entre avaliadores2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.; sensibilidade 73-76,7%, especificidade 74,7-97% e acurácia 85%88 Chatelle C, Majerus S, Whyte J, Laureys S, Schnakers C. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry. 2012;83(12):1233-7.,2222 Vink P, Eskes AM, Lindeboom R, Muckhof P, Vermeulen H. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity. Pain Manag Nurs. 2014;15(4):881-7.. |
