Patients' perceptions and responses to procedural pain: results from Thunder Project II

Am J Crit Care. 2001 Jul;10(4):238-51.

Abstract

Background: Little is known about the painfulness of procedures commonly performed in acute and critical care settings.

Objective: To describe pain associated with turning, wound drain removal, tracheal suctioning, femoral catheter removal, placement of a central venous catheter, and nonburn wound dressing change and frequency of use of analgesics during procedures.

Methods: A comparative, descriptive design was used. Numeric rating scales were used to measure pain intensity and procedural distress; word lists, to measure pain quality.

Results: Data were obtained from 6201 patients: 176 younger than 18 years and 5957 adults. Mean pain intensity scores for turning and tracheal suctioning were 2.80 and 3.00, respectively (scale, 0-5), for 4- to 7-year-olds and 52.0 and 28.1 (scale, 0-100) for 8- to 12-year-olds. For adolescents, mean pain intensity scores for wound dressing change, turning, tracheal suctioning, and wound drain removal were 5 to 7 (scale, 0-10); mean procedural distress scores were 4.83 to 6.00 (scale, 0-10). In adults, mean pain intensity scores for all procedures were 2.65 to 4.93 (scale, 0-10); mean procedural distress scores were 1.89 to 3.47 (scale, 0-10). The most painful and distressing procedures were turning for adults and wound care for adolescents. Procedural pain was often described as sharp, stinging, stabbing, shooting, and awful. Less than 20% of patients received opiates before procedures.

Conclusions: Procedural pain varies considerably and is procedure specific. Because procedures are performed so often, more individualized attention to preparation for and control of procedural pain is warranted.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Analgesics / therapeutic use
  • Australia
  • Canada
  • Catheterization, Central Venous / adverse effects
  • Child
  • Child, Preschool
  • Critical Care / classification
  • Critical Care / methods*
  • Humans
  • Middle Aged
  • Pain / classification*
  • Pain / drug therapy
  • Pain / etiology
  • Pain Measurement* / statistics & numerical data
  • Perception*
  • Suction / adverse effects
  • United Kingdom
  • United States
  • Wounds and Injuries / complications
  • Wounds and Injuries / nursing

Substances

  • Analgesics