Effect of pain control algorithm on pain intensity and duration of patients' connection to the ventilator

Patients undergoing mechanical ventilation cannot self-report pain because of intubation, altered levels of consciousness, and high doses of sedative agents. Therefore, inadequate pain management increases the duration of connection to the ventilator. The aim of this study was to evaluate the effect of pain control algorithm on pain intensity and duration of patientschr('39') connection to ventilator.

This clinical trial was conducted on 396 patients undergoing mechanical ventilation conveniently recruited from intensive care units of teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences (Ahvaz, Iran) from August 2017 to June 2016. Participants were allocated to the intervention (n=198) and control (n=198) groups through permuted block randomization. Block size was four. In the experimental group, pain intensity was measured daily for 10 days using pain behavioral instrument and pain relief was performed based on pain control algorithm. In addition, the two groups were examined daily by a researcher-made checklist for weaning criteria from the ventilator for 10 days.

In the experimental group, pain intensity started to decrease from the first day of intervention (P<0.0001). The connection time to the ventilator was also reduced and this difference was statistically significant compared to the control group (P<0.0001).

The findings of this study showed that the use of pain control algorithm could lead to better pain management and reduce the duration of ventilator connection in patients admitted to intensive care units. However, to increase clinical utility and to achieve more targeted pain treatment, more focus on implement an algorithm and reassessment of patients’ pain is needed.