Journal
JOURNAL OF PAIN RESEARCH
Volume 14, Issue -, Pages 3723-3731Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JPR.S332845
Keywords
nociception; pain; pain assessment; adult; cardiac surgery; intensive care unit
Categories
Funding
- Louise & Alan Edwards Foundation
- Quebec Nursing Intervention Research Network
Ask authors/readers for more resources
The study aimed to explore the use of the Nociception Level (NOL) index for pain assessment in postoperative awake patients after cardiac surgery during non-nociceptive and nociceptive procedures in the ICU. The NOL index was found to be able to discriminate between non-nociceptive and nociceptive procedures and was associated with self-reported pain, but showed only modest performance in detecting pain in this sample. Validation testing of the NOL in a more diverse sample of ICU patients is needed.
Introduction: The aim of this study was to explore the use of a multi-parameter technology, the Nociception Level (NOL) index (Medasense Biometrics Ltd, Ramat Gan, Israel), for pain assessment in postoperative awake patients after cardiac surgery during non-nociceptive and nociceptive procedures in the intensive care unit (ICU). Materials and Methods: A prospective cohort repeated-measures design was used. Patients were included if they were in the ICU after undergoing cardiac surgery and if they could self-report their pain. A non-invasive probe was placed on the patient's finger for the continuous monitoring of the NOL index. Patients' self-reports of pain and anxiety (0-10 Numeric Rating Scale or NRS), and behavioral scores with the Critical-Care Pain Observation Tool (CPOT) were obtained before and during a non-nociceptive procedure (ie, non-invasive blood pressure [NIBP] using cuff inflation), and before, during and after a nociceptive procedure (ie, chest tube removal [CTR]) for a total of five time points. Non parametric tests were used to compare scores at different time points, and receiver operating characteristic curve analysis was performed. Results: Fifty-four patients were included in the analysis. The NOL index, pain and anxiety scores were significantly higher during CTR compared to rest and NIBP (p < 0.001). During CTR, the NOL was associated with self-reported pain intensity and unpleasantness but not with anxiety and CPOT scores. The NOL showed a modest performance in detecting pain (NRS >1 and >5) in this sample with sensitivity and specificity ranging from 61% to 85%. Conclusion: The NOL index was able to discriminate between a non-nociceptive and a nociceptive procedure and was associated with self-reported pain. Further validation testing of the NOL is necessary in a heterogeneous sample of ICU patients.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available