Pain Clinical Trial
Official title:
Pain Associated With ICU Procedures: An International Study
Pain associated with procedures performed on adult ICU patients is ubiquitous and the
subject of research attention.While there is growing evidence about the prevalence,
characteristics and measurement of procedural pain in ICUs, most of this evidence has been
derived from English-speaking patients in the United States who were able to verbally report
the intensity and distress of this pain. Frequently performed procedures include
turning,chest tube removal,wound care/wound dressing change,endotracheal suctioning,central
catheter insertion(arterial/venous, have been a focus for research. Other potentially
painful procedures, including lumbar puncture and physiotherapy,are numerous and have not
been systematically studied in adults.
Patients unable to verbally report their pain have not been able to participate in
procedural pain studies, which has limited the generalizability of study results to a narrow
population of ICU patients.
The Specific Aims of this proposed European-based, international study of ICU patients
undergoing selected procedures are to:
- Describe patient self-reports of pain intensity and distress
- Describe the behaviors exhibited by patients during a procedure, comparing the
behaviors exhibited by those able versus unable to self-report pain intensity and pain
distress
- Examine predictors of amount of pain intensity, behavioral responses, and analgesic use
related to procedures such as gender, age, language spoken, country, and type of
hospital.
Validated pain intensity, pain distress, and behavioral observation instruments will be
methodically translated into the predominant languages spoken in our international study
sites; research and training packets similar to those developed in a large, multisite study
in the United States will be developed and provided to data collection sites; and data
collection will occur over a 6-month period of time. Study data will be analyzed and
disseminated at international meetings and in publications.
Procedures to be studied are the following:
- TURNING (moving side to side in bed)
- POSITIONING (moving up or down in bed)
- MOBILIZATION (getting out of bed or chair)
- RESPIRATORY EXERCISES (cough, deep breathe)
- PERIPHERAL BLOOD DRAW (insertion of catheter into vein in order to draw out blood)
- PERIPHERAL IV INSERTION (insertion of catheter into vein in order to give medications
or fluids)
- ARTERIAL LINE INSERTION (insertion of arterial catheter for blood pressure monitoring
and arterial blood draws)
- ENDOTRACHEAL SUCTIONING (insertion of suction catheter into endotracheal tube in order
to aspirate secretions)
- TRACHEAL SUCTIONING (insertion of suction catheter into a tracheostomy in order to
aspirate secretions)
- CHEST TUBE REMOVAL (removal of a tube from the mediastinum or plural space)
- WOUND DRAIN REMOVAL (removal of a drain from a wound such as a drain inserted during
abdominal surgery)
- WOUND CARE (i.e., cleaning, dressing change)
;
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