Adaptación de la escala ESCID para medir el dolor en pacientes críticos con daño cerebral

  1. Candelas López-López
  2. Antonio Arranz-Esteban
  3. Mª del Mar Sánchez-Sánchez
  4. Ignacio Latorre-Marco
  5. María Acevedo-Nuevo
  6. Susana Arias-Rivera
  7. Montserrat Solís-Muñoz
  8. Ana Rodríguez-Gonzalo
  9. Santiago Pérez-García
Journal:
Metas de enfermería

ISSN: 1138-7262

Year of publication: 2018

Volume: 21

Issue: 9

Pages: 27-31

Type: Article

DOI: 10.35667/METASENF.2019.21.1003081316 DIALNET GOOGLE SCHOLAR

More publications in: Metas de enfermería

Sustainable development goals

Abstract

Objective: to evaluate the validity of the concept and the reliability of the adaptation of the Scale of Behavior Indicators of Pain (ESCID) in order to assess pain in critical patients with brain damage, who are non-communicative and undergoing mechanical ventilation. Method: subjects: a multicenter observational study. It will be conducted on critical patients with acquired brain damage, of age, undergoing invasive mechanical ventilation, and unable to communicate, who have been admitted to intensive care units from four 3rd level University Hospitals from the Community of Madrid. Pain will be evaluated in all subjects with two instruments simultaneously (ESCID-DC and video recording). Pain evaluation through ESCID-DC will be conducted by two independent observers with blind results between them, with the application of two painful procedures (aspiration of tracheal secretions and pressure on the nail bed) and a non-painful procedure. Measurement will only be conducted once per patient and procedure. Pain measurement will be conducted at three time points: five minutes before, during, and fifteen minutes after each procedure. Five minutes before initiating the procedure and up to ten minutes afterwards, two video cameras will capture images and audio (one will focus on the entire body, the other one only on the face), in order to capture and subsequently analyze the gestural and body changes of the subject at each moment, and to be able to correlate them with the eight behavior indicators of the ESCID-DC scale. Conclusions: the availability of this type of scale, with good psychometric properties, will improve pain management for patients with brain damage and, therefore, treatment efficacy.

Bibliographic References

  • Díaz-Guzmán J, Egido-Herrero JA, Gabriel-Sánchez R, Barbera G, Fuentes B, Fernández-Pérez C, et al. Incidence of strokes in Spain. Methodological foundations of the Iberictus study. Rev Neurol 2008; 47(12):617-23.
  • Peeters W, van den Brande R, Polinder S, Brazinova A, Steyerberg EW, Lingsma HF, et al. Epidemiology of traumatic brain injury in Europe. Acta Neurochir (Wien) 2015; 157(10):1683-96.
  • Giacino JT, Fins JJ, Laureys S, Schiff ND. Disorders of consciousness after acquired brain injury: the state of the science. Nat Rev Neurol 2014; 10(2):99-114.
  • Flexman AM, Ng JL, Gelb AW. Acute and chronic pain following craniotomy. Curr Opin Anaesthesiol 2010; 23(5):551-7.
  • Gottschalk A, Yaster M. The perioperative management of pain from intracranial surgery. Neurocrit Care 2009; 10(3): 387-402.
  • Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013; 41(1):263-306.
  • 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.
  • Gelinas 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.
  • 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.
  • Riker RR, Fugate JE, participants in the International Multi-disciplinary Consensus Conference on Multimodality Monitoring. Multi-disciplinary Consensus Conference on Multimodality Monitoring. Clinical monitoring scales in acute brain injury: assessment of coma, pain, agitation, and delirium. Neurocrit Care. 2014; 21 Suppl 2:S27-37.
  • Latorre Marco I, Solís Muñoz M, Falero Ruiz T, Larrasquitu Sánchez A, Romay Pérez A, Millán Santos I. Validación de la Escala de Conductas Indicadoras de Dolor para valorar el dolor en pacientes críticos, no comunicativos y sometidos a ventilación mecánica: resultados del proyecto ESCID. Enferm Intensiva 2011; 22(1):3-12.
  • Latorre-Marco I, Acevedo-Nuevo M, Solís-Muñoz M, Hernández-Sánchez L, López-López C, Sánchez-Sánchez MM, et al. Psychometric validation of the behavioral indicators of pain scale for the assessment of pain in mechanically ventilated and unable to self-report critical care patients. Med Intensiva. 2016; 40(8):463-73.
  • López López C. Valoración del dolor en el paciente con trauma grave y ventilación mecánica no comunicativo. Madrid: Universidad Complutense de Madrid (UCM); 2015.
  • Streiner DL, Kottner J. Recommendations for reporting the results of studies of instrument and scale development and testing. J Adv Nurs 2014; 70(9):1970-9.
  • Cicchetti DV. The precision of reliability and validity estimates re-visited: distinguishing between clinical and statistical significance of sample size requirements. J Clin Exp Neuropsychol 2001; 23(5):695-700.
  • Puntillo KA, Max A, Timsit JF, Vignoud L, Chanques G, Robleda G, et al. Determinants of procedural pain intensity in the intensive care unit. The Europain(R) study. Am J Respir Crit Care Med 2014; 189(1):39-47.
  • 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.