Impact of Pain Management Algorithm on Pain Intensity of Patients with Loss of Consciousness Hospitalized in Intensive Care Unit: A Clinical Trial

Abstract

Background: Pain management programs in the case of patients with loss of consciousness could be advantageous inasmuch as they reduce the use of sedatives, prevent long hospitalization, and diminish the cost of treatment, medications, and hospitalization. Objectives: The present study aims to evaluate the effect of pain management algorithm on pain intensity in patients with loss of consciousness who had been hospitalized in an intensive care unit (ICU) in 2017. Methods: In this randomized single-blind clinical trial, 90 patients with loss of consciousness who were under mechanical ventilation and admitted to the ICU of Khatam al-Anbiya Hospital, Zahedan were chosen through convenience sampling. Using permuted block randomization, the subjects were then assigned into intervention and control groups. Pain management algorithm was implemented in the intervention group for 24 hours during the morning shift between 8 a.m. and 10 a.m., during the evening shift between 3 p.m. and 5 p.m., and during the night shift between 10 p.m. and midnight. On the other hand, participants in the control group only received the routine care provided in the ward. Pain intensity was measured and recorded in both groups before and after the intervention. The tools used in this study included a demographic information form and the Behavioral Pain Scale (BPS). The data were analyzed in SPSS 15 using descriptive statistics, paired and independent t-tests, and chi-square. Results: There was no significant difference between the two groups in terms of gender, age, marital status, and the infused medications. The mean value of pain intensity in patients of the intervention group decreased after receiving the intervention for three shifts, and a significant difference was detected in the mean of this value before and after implementing the intervention. Conversely, the difference of the same variable in the control group was not significant before and after the intervention. In addition, the two groups significantly differed with regard to the mean changes of pain intensity during each of the three shifts (P < 0.001). Conclusions: Implementation of the pain management algorithm can significantly improve pain management in patients with loss of consciousness.