JULIO 2009 N° 7 Volumen 7

Validation of a scale to assess pain in critical, non-communicative patients on mechanical ventilation



Ignacio Latorre Marco1, Laura Betrán Calvo1, Isabel Várez Hernández1, Itziar C Chavarri del Hoyo1, Teresa Falero Ruiz1, Elia


Enfermeros y enfermeras de la Unidad de Cuidados Intensivos Médicos del Hospital Universitario Puerta de Hierro Majadahonda, Madrid1

Contact address

Ignacio Latorre Marco. Hospital Universitario Puerta de Hierro. Majadahonda, UCI Médica. C/ Manuel de Falla, 1. 28222 Majadahonda, Madrid.

Contact email: Ntx_2002@yahoo.es


Objectives: to determine the validity of a new scale developed to assess pain in critical, non-communicative patients on mechanical ventilation.
Methods: observational study on the elaboration and validation of a scale as a measurement instrument. Fifty (50) patients admitted into the Intensive Care Unit of the Puerta del Hierro university hospital (Madrid)  will be included in the study. The inclusion criteria will be: patients aged 18 and over, to be on mechanical ventilation, inability to communicate, either verbally or by sings, signed informed consent from the patient’s next of kin or legal guardian. Procedure: Pain will be assessed in the subjects by two independent observers using the double-blind method, coinciding with the application of two common procedures in routine clinical practice that have been reported as painful: mobilisation or postural change and suctioning of tracheal secretions. Pain assessment will be carried at three different moments in time: first or baseline measurement: 5-10 minutes before the painful procedure. Second measurement: during the application of the painful process. Third or recovery period measurement: 15 minutes after completion of the procedure. Variables: Pain assessment measurements via the application of the “Behavioural Pain Scale” and Pain Behaviour scales. Clinical data: these data will be collected at the different measurement times of the procedure and will include Herat rate, blood pressure and bispectral index (BIS) value (in those patients in which it might be available). The Glasgow Scale score  (GCS) and Richmond Agitation Sedation Scale (RASS) will only be assessed at the baseline measurement. Data will also be collected on: patient pathology, physician’s orders on analgesic and sedation medication. Socio-demographic data. Instruments: two scales will be used simultaneously: The Behavioural Pain Scale, a validated scale consisting of three items and the scale under study Pain Behaviour Scale. It is a proposed modification to Campbell’s scale, with scores from 0 to 2, with 5 behavioural items.
Applicability: the development and application of the  ESCID scale will facilitate the detection and quantification of pain, contributing to reduce pain-associated complications, and the increase in morbidity and mortality derived from these complications.


pain; scale; Mechanical ventilation; investigation; project

Versión en Español


Validación de una escala para la valoración del dolor en pacientes críticos, no comunicativos y sometidos a ventilación mecánica