| Abstract [eng] |
Introduction. Pain in the intensive care unit is a common and clinically significant problem that affects patient outcomes, hospital course, and quality of care. Pain assessment is challenging because some critically ill patients are unable to reliably express discomfort due to intubation, sedation, altered consciousness, or cognitive impairment. Although patient self-report is considered the most reliable method, alternative observation-based tools are required for sedated and non-communicative patients. Aim. To summarize current evidence on pain assessment in sedated intensive care unit patients, with particular focus on the clinical application of the Behavioral Pain Scale and the Critical-Care Pain Observation Tool. Methods. A narrative literature review was conducted using the PubMed database. International guidelines, systematic reviews, clinical studies, validation studies, and meta-analyses published between 2016 and 2026 were analyzed. The following keywords were used: pain assessment, intensive care unit, sedated patients, Behavioral Pain Scale, Critical-Care Pain Observation Tool, and analgesia. A total of 25 sources were included in the final review. Results. Physiological parameters are not sufficiently specific indicators of pain and should not be used as the sole basis for assessment. Validated behavioral scales are recommended. The Behavioral Pain Scale evaluates facial expression, upper limb movements, and compliance with mechanical ventilation. The Critical-Care Pain Observation Tool additionally assesses body movements, muscle tension, and compliance with ventilation or vocalization. Both scales demonstrate acceptable reliability and validity, although their diagnostic accuracy depends on clinical context and observer training. Conclusions.Pain assessment in sedated intensive care patients should be systematic and based on validated tools. The Behavioral Pain Scale and the Critical-Care Pain Observation Tool are practical instruments; however, their results must be interpreted within the clinical context. |
