Application of the critical-care pain observation tool for pain assessment in intracranial tumor patients after craniotomy

doi:10.3969/j.issn.1006-7795.2019.05.018

Abstract

Abstract: Objective To evaluate the reliability and validity of the critical-care pain observation tool (CPOT) for pain assessment in intracranial tumor patients after craniotomy. Methods This prospective study was enrolled intracranial tumor patients after craniotomy undergoing mechanical ventilation in the intensive care unit (ICU). Nociceptive and non-nociceptive operations were performed in a random crossover manner. Two researchers completed CPOT evaluation before and after the operation, and another researcher performed pain evaluation after the operation. Patients were divided into two groups according to whether they could self-report pain. The intraclass correlation coefficient (ICC) was used to compare the reliability of CPOT between the two researchers. By using self-reported pain as the reference, the receiver operating characteristic (ROC) curve of CPOT and vital signs was drawn, and the area under the curve (AUC) and 95% confidence intervals (CI) were calculated. Changes in CPOT and vital signs before and after different operations were compared in patients without self-reported pain. Results A total of 243 patients were enrolled, 171 (70.4%) were able to complain self-report pain. It was maintained in 151 (88.3%) and 34 (19.9%) patients complained pain during nociceptive and non-nociceptive operations, respectively. The ICC range of patients with self-reported pain or not before and after different operations was between 0.790 and 0.945. For patients with self-reported pain, the AUC and 95% CI for CPOT were 0.805 (0.759-0.852) (P<0.001). For patients without self-reported pain, CPOT was increased significantly after nociceptive operation. Conclusion CPOT has good reliability and validity for pain assessment in intracranial tumor patients after craniocerebral craniotomy. It could also distinguish the differences between nociceptive and non-nociceptive operations in patients without self-report pain.

Key words: critical-care pain observation tool, intracranial tumor, craniotomy, pain assessment

CLC Number:

R651

Yang Yanlin, Chen Guangqiang, He Xuan, Shi Zhonghua, Xu Ming, Zhou Jianxin. Application of the critical-care pain observation tool for pain assessment in intracranial tumor patients after craniotomy[J]. Journal of Capital Medical University, 2019, 40(5): 758-763.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2019.05.018

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2019/V40/I5/758

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