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RES19
Management Of Pain In Cardiac Surgery ICU Patients: Have We Improved Over Time?
By: Gelinas, C., Fillion, L., Viens, C. & Puntillo, K.; McGill University, Montreal
For further information, please contact: celine.gelinas@mcgill.ca
Purpose : This study described pain experience of cardiac surgery ICU patients.
Background and significance : Research to date has highlighted the under-assessment and under-treatment of pain in critically ill patients. Since pain is a symptom, a patient’s experience has to be well understood so that pain can be assessed and treated properly.
Methods : A descriptive design was used for this study. Ninety-three cardiac surgery patients were interviewed, using a questionnaire, about their pain experience while they were in the ICU after they had been transferred to the surgery unit. Descriptive statistics were calculated.
Results : Some patients (n=21) were not able to recall their pain experience at the ICU. Another 72 cardiac surgery patients participated. Patients were interviewed one to two days after their transfer from the ICU (average length of ICU stay: two days) to the surgery unit. Seventy-two patients (77.4%) recalled having pain and sixty-one (65.6%) recalled being intubated. Moving, coughing / breathing and chest tube removal were the three most frequent sources of pain experienced by patients. A large proportion of patients (47.3%) identified the thorax as the location of their pain. All patients had a sternotomy. Pain was mild for 16 patients, moderate for 21 and severe for 25 of them. While intubated, patients mentioned using different means to communicate having pain: head nodding, moving arms and hands, grimacing, and using the bell.
Conclusions : In spite of advances in pain management, study findings are disturbingly similar to those of 17 years ago (Puntillo, 1990). Evidence from research about effectiveness of pain interventions needs to be applied to the care of cardiac surgery patients in order to decrease patient suffering.
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