Use of Behavioural Pain Scale in assessing pain during physical therapy procedures in sedated, mechanically ventilated patients in ICU: A cross-sectional observational study

Abstract

Background: Critically ill patients who are sedated and mechanically ventilated, experience significant pain during physical therapy procedures but cannot communicate effectively due to sedation. Identification and evaluation of pain with validated behavioral observation tools in patients unable to self-report pain improve quality of care by administration of appropriate analgesia or sedation during routine physical therapy care of ventilated patients. Aims and Objectives: This study aimed to assess pain in sedated, mechanically ventilated patients using the Behavioural Pain Scale (BPS) during physical therapy procedures like body positioning and tracheal suctioning. Materials and Methods: Following ethical approval, 50 adult patients, sedated and mechanically ventilated, admitted in the ICUs in a tertiary care teaching hospital were assessed for pain severity using BPS during routine physical therapy procedures. Patients ≥18 years of age, both male and female, with Glasgow Coma Scale of (GCS) < 10, were included in the study. Patients with Ramsay Sedation Scale (RSS) of 3, 4, and 5, mechanically ventilated for at least 48 hours, who were unable to verbalize, patients who were undergoing routine physical therapy that included body positioning and tracheal suctioning for removal of secretion were included. Patients below 18 years of age, able to verbalize pain, and GCS score of ≤ 3, were excluded from the study. Conclusion: BPS is recommended for better pain evaluation during physical therapy procedures in sedated, mechanically ventilated adult patients in the ICU.