The following is a summary of “Assessment of Procedural Pain in Patients with COVID-19 in the Intensive Care Unit” published in the October 2022 issue of Pain Management by Erden et al.
The purpose of this research was to quantify the level of discomfort associated with various medical procedures for patients undergoing treatment in the COVID-19 critical care unit at a major university hospital. The pain experienced by 162 (93.6% of 173) hospitalized patients with COVID-19 was assessed during this study.
Patient practices such as endotracheal aspiration, wound care, and position changes were evaluated for pain before, during, and 20 minutes after the procedure, while prone positioning, high-flow oxygen therapy (HFOT), and the non-invasive mechanical ventilation (NIMV) procedure were evaluated for pain before, during, and up to 4 hours after the procedure. The Numerical Pain Scale was used to assess pain in awake individuals, while the Behavioral Pain Scale and Richmond Agitation-Sedation Scale were used for their unconscious counterparts. During the actual procedure, individuals experiencing endotracheal aspiration, wound care, and placement reported the highest pain levels.
Patients who were placed in the prone position and given HFOT and NIMV reported the highest pain 4 hours later; this increase was statistically significant (P=.000, P<.05). Patients with COVID-19 in the intensive care unit reported more difficulty from shorter operations like endotracheal aspiration, wound care, and positioning than from lengthier procedures like mechanical ventilation. In addition, there was a correlation between prone positioning and pressure-related tissue injury, and patients reported higher pain as the duration of the HFOT and NIMV procedure increased.