Pain evaluation in the intensive care unit: observer-reported faces scale compared with self-reported visual analog scale.
Pain evaluation in the intensive care unit: observer-reported faces scale compared with self-reported visual analog scale.
复制标题
重症监护室的疼痛评估：观察者报告的面部量表与自我报告的视觉模拟量表进行比较。
DOI：
10.1097/00115550-199823020-00006
复制
发表时间：
1998
影响因子：
5.1
通讯作者：
A. Asada
中科院分区：
文献类型：
--
作者：
T. Terai;H. Yukioka;A. Asada
背景与目的视觉模拟评分(VAS)是一种简单、灵敏的疼痛评估方法。面孔量表也是一种简单的儿童自我报告方法。在重症监护病房(ICU)中，面部疼痛症状尚未被用来评估术后成人患者的疼痛。方法对50例食管癌胸腹联合手术患者的临床资料进行分析。术中和术后分别给予硬膜外阿片类药物，如吗啡或丁丙诺啡联合布比卡因。ICU的医生在气管拔管后0.5小时、1小时、2小时、4小时和6小时，此后在ICU期间每隔4小时进行一次疼痛测量。一位不知道患者VAS评分的护士在VAS疼痛评估之前立即使用五级脸部量表评估了面部表情作为疼痛强度的衡量标准。VAS被重新调整为五个独立的单位，与五个面孔量表的分数相匹配。使用加权kappa统计建立五级VAS和FACES量表之间的相对一致性水平。结果5级VAS评分与拔管后30min和1h的Face评分有较好的一致性(加权kappa值分别为0.67和0.62)。在ICU期间，对每位患者进行7-13次VAS和Face评分，共收集518个观察点。虽然在所有观察对中，五级VAS和Face量表之间有中等的一致性(加权kappa值.54)，但在中度疼痛的患者中，它们之间的一致性较小。此外，五级VAS和面孔评分之间的计算平均差异在患者之间存在显著差异。结论面孔评分可用于ICU患者的疼痛评估。
Background and Objectives The visual analog scale (VAS) is a simple and sensitive mean of pain assessment. The faces scale is also a simple, self-reporting method for children. Facial signs of pain have not been used to assess pain in postoperative adult patients in the intensive care unit (ICU). Methods Fifty patients undergoing esophageal cancer surgery by a thoracoabdominal procedure were studied. Epidural opioids, such as morphine or buprenorphine, combined with bupivacaine were administered during and after surgery. Pain measurement was performed by a physician in the ICU using the self-reported VAS 0.5, 1, 2, 4, and 6 hours after tracheal extubation and thereafter every 4 hours during the stay in the ICU. A nurse who was unaware of the patients9 VAS scores assessed facial expression as a measure of pain intensity using a five-grade faces scale immediately before pain evaluation by VAS. The VAS was rescaled into five discrete units that would match the five faces scale scores. Weighted kappa statistics were used to establish a relative level of agreement between the five-grade VAS and faces scale. Results Good agreement was found between the five-grade VAS and the faces scale 30 minutes and 1 hour after tracheal extubation (weighted kappa values .67 and .62, respectively). The VAS and faces scales were measured 7-13 times per patient during the stay in the ICU, and 518 observations were collected. Although moderate agreement was found between the five-graded VAS and faces scale for all pairs of observation (weighted kappa values .54), less agreement was found between them in patients with moderate pain. In addition, the calculated mean differences between the five-graded VAS and faces scale differed significantly between patients. Conclusion The faces scale may be useful for pain evaluation in the ICU.
影响因子：
168.9
作者：
HUSKISSON, EC
通讯作者：
HUSKISSON, EC