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The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature

BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioura...

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Autores principales: Coleman, Robin Marie, Tousignant-Laflamme, Yannick, Ouellet, Paul, Parenteau-Goudreault, Élizabeth, Cogan, Jennifer, Bourgault, Patricia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pulsus Group Inc 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325898/
https://www.ncbi.nlm.nih.gov/pubmed/25050877
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author Coleman, Robin Marie
Tousignant-Laflamme, Yannick
Ouellet, Paul
Parenteau-Goudreault, Élizabeth
Cogan, Jennifer
Bourgault, Patricia
author_facet Coleman, Robin Marie
Tousignant-Laflamme, Yannick
Ouellet, Paul
Parenteau-Goudreault, Élizabeth
Cogan, Jennifer
Bourgault, Patricia
author_sort Coleman, Robin Marie
collection PubMed
description BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia. OBJECTIVES: To synthesize the main studies exploring the use of the bispectral index monitoring system for pain assessment, to guide future research in adults under sedation in the intensive care unit. METHOD: The EMBASE, Medline, CINAHL and PsycINFO databases were searched for studies published between 1996 and 2013 that evaluated the use of the bispectral index in assessing pain. RESULTS: Most studies conclude that nociceptive stimulation causes a significant increase in the bispectral index and revealed the importance of controlling certain confounding variables such as the level of sedation. DISCUSSION: Further studies are needed to clearly demonstrate the relationship between nociceptive stimuli and the bispectral index, as well as the specificity of the bispectral index in detecting pain.
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spelling pubmed-43258982015-02-26 The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature Coleman, Robin Marie Tousignant-Laflamme, Yannick Ouellet, Paul Parenteau-Goudreault, Élizabeth Cogan, Jennifer Bourgault, Patricia Pain Res Manag Review BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia. OBJECTIVES: To synthesize the main studies exploring the use of the bispectral index monitoring system for pain assessment, to guide future research in adults under sedation in the intensive care unit. METHOD: The EMBASE, Medline, CINAHL and PsycINFO databases were searched for studies published between 1996 and 2013 that evaluated the use of the bispectral index in assessing pain. RESULTS: Most studies conclude that nociceptive stimulation causes a significant increase in the bispectral index and revealed the importance of controlling certain confounding variables such as the level of sedation. DISCUSSION: Further studies are needed to clearly demonstrate the relationship between nociceptive stimuli and the bispectral index, as well as the specificity of the bispectral index in detecting pain. Pulsus Group Inc 2015 /pmc/articles/PMC4325898/ /pubmed/25050877 Text en © 2015, Pulsus Group Inc. All rights reserved This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact support@pulsus.com
spellingShingle Review
Coleman, Robin Marie
Tousignant-Laflamme, Yannick
Ouellet, Paul
Parenteau-Goudreault, Élizabeth
Cogan, Jennifer
Bourgault, Patricia
The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title_full The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title_fullStr The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title_full_unstemmed The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title_short The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature
title_sort use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: a review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325898/
https://www.ncbi.nlm.nih.gov/pubmed/25050877
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