Abstract:
The induced pain (procedural pain) is a short-term pain caused by a doctor or other medical
staff during therapeutic or diagnostic action in foreseeable circumstances and likely to be prevented
by adopted measures. Induced pain prevalence is between 43-56% for adults, 59% - for children and
up to 93% - for newborns. Over 660 painful gestures were identified, with an average of 1.8 gestures
per patient per day. From all studied painful gestures, intense pain and extremely intense pain was
attested at 57% of patients. Scheduled treatment of postoperative pain has no influence on induced
pain. So, it is imperative to ensure additional analgesic treatment. At our knowledge, the induced pain
was no subject to any study in Republic of Moldova till now. Therefore, we aimed to describe
incidence and pain intensity for some sources of induced pain in the intensive care unit (ICU) and to
identify any gender differences. The study included 99 adult patients (M - 39 F - 60), hospitalized
postoperatively in ICU. Patients completed a specifically designed questionnaire, where they noted
supported painfully diagnostic or therapeutic interventions and also, the intensify of pain (assessed by
visual-rating score VRS 0-10). Statistical tests used: t-Student, СЫ2 with Yates correction. One
p<0.05 was considered statistically significant. Both groups (M vs. F) were comparable according to
level of education, ASA score, and range of interventions. Instead, F group were significantly older
(61.7 ± 14.7 [95CI: 57,9-65,4] vs 47.1 ± 15.0 [95CI: 42,2-52,0] years, p<0.0001). Spectrum and
incidence of induced pain sources were recorded (M vs F): intravenous injection (97-98%),
intramuscular injection (87-95%), bladder catheterization (79-88%), dressings (79-83%), wound
drains (59-60%), neuraxial puncture (49-48 %), peripheral venous line (51-48%), tracheal tube (36
47%), naso-gastric tube (33-30%), arterial puncture (18-23%) with no significant differences between groups. The only exception: subclavian vein catheterization was more common in women because of
more advanced age of patients in group (20% vs 10%, pO.OOOl). As very painful (SVA>5) were
reported: arterial puncture (in 50% cases), subclavian vein catheterization (22%), neuraxial puncture
(13%), nasogastric tube (12%), bladder catheterization (12%), peripheral venous line (7%), and other
interventions (<5%). The conclusions are: 1) induced pain in intensive care unit has an extremely
high incidence, intensity and variety of sources. 2) Generally were not identified gender differences in
the spectrum, frequency and intensity of induced pain.
