Background: Critically ill patients who are sedated and mechanically
ventilated, experience significant pain during physical therapy procedures
but cannot communicate effectively due to sedation. Identification and
evaluation of pain with validated behavioral observation tools in patients
unable to self-report pain improve quality of care by administration of
appropriate analgesia or sedation during routine physical therapy care of
ventilated patients. Aims and Objectives: This study aimed to assess pain in
sedated, mechanically ventilated patients using the Behavioural Pain Scale
(BPS) during physical therapy procedures like body positioning and tracheal
suctioning. Materials and Methods: Following ethical approval, 50 adult
patients, sedated and mechanically ventilated, admitted in the ICUs in a
tertiary care teaching hospital were assessed for pain severity using BPS
during routine physical therapy procedures. Patients ≥18 years of age, both
male and female, with Glasgow Coma Scale of (GCS) < 10, were included in
the study. Patients with Ramsay Sedation Scale (RSS) of 3, 4, and 5,
mechanically ventilated for at least 48 hours, who were unable to verbalize,
patients who were undergoing routine physical therapy that included body
positioning and tracheal suctioning for removal of secretion were included.
Patients below 18 years of age, able to verbalize pain, and GCS score of ≤ 3,
were excluded from the study. Conclusion: BPS is recommended for better
pain evaluation during physical therapy procedures in sedated, mechanically
ventilated adult patients in the ICU.
Keywords: Pain, Behavioural Pain Scale, Mechanical Ventilation, ICU,
Physical Therapy Procedures
