Assessment and detection of pain in noncommunicative severely brain-injured patients.

[en] Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their feelings and potential perception of pain. However, recent studies suggest that patients in a minimally conscious state can experience pain to some extent. Pain monitoring in these patients is hence of medical and ethical importance. In this article, we will focus on the possible use of behavioral scales for the assessment and detection of pain in noncommunicative patients.

Disciplines :

Neurology

Author, co-author :

Schnakers, Caroline ; coma science group, centre de recherches du cyclotron ULiège & service de neurologie CHU de Liège

Chatelle, Camille ; coma science group, centre de recherches du cyclotron ULiège & service de neurologie CHU de Liège

Majerus, Steve ; Université de Liège - ULiège > Département de Psychologie : cognition et comportement > Psychopathologie cognitive

Gosseries, Olivia ; coma science group, centre de recherches du cyclotron ULiège & service de neurologie CHU de Liège

De Val, Marie; University Hospital of Charleroi > Department of Intensive Care

Laureys, Steven ; coma science group, centre de recherches du cyclotron ULiège & service de neurologie CHU de Liège

Language :

English

Title :

Assessment and detection of pain in noncommunicative severely brain-injured patients.

Publication date :

2010

Journal title :

Expert Review of Neurotherapeutics

ISSN :

1473-7175

eISSN :

1744-8360

Publisher :

Future Medicine Ltd

Volume :

Issue :

Pages :

1725-31

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 12 January 2012

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Bibliography

Schnakers C, Zasler ND. Pain assessment and management in disorders of consciousness. Curr Opin Neurol 20 (6), 620-626 (2007).
IASP. Classifcation of Chronic Pain: Descriptions of Chronic Pain Syndromes and Defnitions of Pain Terms. Task Force on Taxonomy. IASP Press, WA, USA (1994).
Giacino J, Ashwal S, Childs N et al. The minimally conscious state: defnition and diagnostic criteria. Neurology 58(3), 349-353 (2002).
Boly M, Faymonville ME, Schnakers C et al. Perception of pain in the minimally conscious state with PET activation: an observational study. Lancet Neurol 7(11), 1013-1020 (2008).
Schnakers C, Chatelle C, Vanhaudenhuyse A et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain 148(2), 215-219 (2010).
The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state (1). N. Engl. J. Med. 330(21), 1499-1508 (1994)
Working Party of the Royal College of Physicians. The vegetative state: guidance on diagnosis and management. Clin. Med. 3(3), 249-254 (2003).
Giacino J. The vegetative and minimally conscious states: a comparison of clinical features and functional outcome. J. Head Trauma Rehabil. 12, 36-51 (1997).
Fins JJ, Schiff ND, Foley KM. Late recovery from the minimally conscious state: ethical and policy implications. Neurology 68(4), 304-307 (2007).
Lammi MH, Smith VH, Tate RL et al The minimally conscious state and recovery potential: a follow-up study 2 to 5 years after traumatic brain injury Arch. Phys. Med. Rehabil. 86(4), 746-754 (2005).
Borsook D, Becerra LR. Breaking down the barriers: fMRI applications in pain, analgesia and analgesics. Mol Pain 2, 30 (2006).
May A. Neuroimaging: visualising the brain in pain. Neurol. Sci. 28 (2), 101-107 (2007).
Baars B, Ramsoy T, Laureys S. Brain, conscious experience and the observing self. Trends Neurosci. 26, 671-675 (2003).
Laureys S, Faymonville ME, Peigneux P et al. Cortical processing of noxious somatosensory stimuli in the persistent vegetative state. Neuroimage 17(2), 732-741 (2002).
Kassubek J, Juengling FD, Els T et al. Activation of a residual cortical network during painful stimulation in long-term postanoxic vegetative state: a 15O-H2O PET study. J. Neurol. Sci. 212(1-2), 85-91 (2003).
Laureys S, Goldman S, Phillips C et al. Impaired effective cortical connectivity in vegetative state: preliminary investigation using PET. Neuroimage 9(4), 377-382 (1999).
Stevens RD, Nyquist PA. Coma, delirium, and cognitive dysfunction in critical illness. Crit. Care Clin. 22(4), 787-804 (2006).
Zwakhalen SM, Hamers JP, Abu-Saad HH et al. Pain in elderly people with severe dementia: a systematic review of behavioural pain assessment tools. BMC Geriatr. 6, 3 (2006).
Lefebre-Chapiro L. The Doloplus 2 scale-evaluating pain in the elderly. Eur. J. Pall. Care 8, 191-194 (2001).
Fuchs-Lacelle S, Hadjistavropoulos T Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Manag. Nurs 1, 37-49 (2004).
Morello R, Jean A, Alix M, Sellin-Peres D, Fermanian J. A scale to measure pain in non-verbally communicating older patients: the EPCA-2 Study of its psychometric properties. Pain 133(1-3), 87-98 (2007).
Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J. Am. Med. Dir. Assoc. 4(1), 9-15 (2003).
Hummel P, Van Dijk M. Pain assessment: current status and challenges. Semin. Fetal Neonatal Med. 11(4), 237-245 (2006).
Herr K, Coyne PJ, Key T et al. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Manag. Nurs. 7, 44-52 (2006).
Stevens B, Johnston C, Petryshen P, Taddio A. Premature infant pain profle: development and initial validation. Clin. J. Pain 12, 13-22 (1996).
Lawrence J, Alcock D, McGrath P et al. The development of a tool to assess neonatal pain. Neonatal Netw. 12(6), 59-66 (1993).
Merkel SI, Voepel-Lewis T, Shayevitz JR et al. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr. Nurs. 23(3), 293-297 (1997).
Pudas-Tahka SM, Axelin A, Aantaa R et al. Pain assessment tools for unconscious or sedated intensive care patients: a systematic review. J. Adv. Nurs. 65(5), 946-956 (2008).
Ambuel B, Hamlett KW, Marx CM. Assessing distress in pediatric intensive care environments: the Comfort Scale. J. Pediatr. Psychol. 17, 95-109 (1992).
Payen JF, Bru O, Bosson JL et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit. Care Med. 29, 2258-2263 (2001).
Chatelle C, Vanhaudenhuyse A, Mergam AN et al. Pain assessment in noncommunicative patients. Rev. Med. Liege 63(5-6), 429-437 (2008).
Sessler CN, Grap MJ, Ramsay MA. Evaluating and monitoring analgesia and sedation in the intensive care unit. Crit Care 12 (3), 2 (2008).
De Val M, Pachioli M, Lorent C et al. Assessment of pain in the intensive care unit in patients who cannot communicate: clinical interest of the SOS DOLOUSI, a Behavioural Pain Scale. Presented at: 3rd European Critical Care Nursing Congress, Florence, Italy, 9-11 October 2008.
young children: a comprehensive report on seven consecutive studies. Paediatr. Anaesth. 10(3), 303-318 (2000).
Herr KA, Garand L. Assessment and measurement of pain in older adults. Clin. Geriatr. Med. 17(3), 457-478 (2001).
Chatelle C, Schnakers C, Vanhaudenhuyse A et al. The Nociception Coma Scale to assess nociception in disorders of consciousness. Presented at: 8th World Congress on Brain Injury, Washington, USA, 10-14 March 2010.
Schnakers C, Perrin F, Schabus M et al. Voluntary brain processing in disorders of consciousness. Neurology 71(20), 1614-1620 (2008).
Wijdicks EF. Minimally conscious state vs. persistent vegetative state: the case of Terry (Wallis) vs the case of Terri (Schiavo). Mayo Clin. Proc. 81(9), 1155-1158 (2006).
Demertzi, A, Schnakers C, Ledoux D et al. Different beliefs about pain perception in the vegetative and minimally conscious states: a European survey of medical and paramedical professionals. Prog. Brain Res. 177, 329-338 (2009).
Haenggi M, Ypparila-Wolters H, Bieri C et al, Entropy and bispectral index for assessment of sedation, analgesia and the effects of unpleasant stimuli in critically ill patients: an observational study. Crit. Care 12(5), 186 (2008).
Schnakers C, Majerus S, Laureys S. Bispectral analysis of electroencephalogram signals during recovery from coma: preliminary fndings. Neuropsychol. Rehabil. 15(3-4), 381-388 (2005).
Schnakers C, Ledoux D, Majerus S et al. Diagnostic and prognostic use of bispectral index in coma, vegetative state and related disorders. Brain Inj. 22(12), 926-931 (2008).
Owen A, Coleman M, Boly M et al. Detecting awareness in the vegetative state. Science 313(5792), 1402 (2006).
Monti M, Vanhaudenhuyse A, Coleman MR et al. Willful modulation of brain activity in disorders of consciousness. N. Engl. J. Med. 362, 579-589 (2010).