Behavioral and Physiological Pain Responses in Brain-Injured Patients Who Are Unable to Communicate in the Intensive Care Unit

摘要: Abstract Background Assessing pain of critically ill patients with brain injuries who are unable to communicate is a challenge. Current behavioral scales limited in accurate assessments for this population. Aims This study sought investigate the and physiological responses induced by routine painful procedures communicate. Methods Using repeated-measure within-subject observational design, 12 participants admitted an intensive care unit were observed before, during, 15 minutes after nonnociceptive (noninvasive blood pressure measurement) procedure three nociceptive (suctioning, turning, trapezius pinch) procedures. During each assessment, patients’ using video cameras bedside monitors. Results In overall procedures, clenched teeth tense jaw, frowning, orbit tightening, closing eyes, eye movement, fixation-staring, flushing, flexion withdrawal arm, leg, muscle rigidity, twitching, coughing more frequently during than before (p  Conclusions The findings can be used as basis assessment development tools brain-injured However, since may influenced various factors besides pain, changes sign need rather being alone assessment.