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Validation of a New "Objective Pain Score" Vs. "Numeric Rating Scale" For the Evaluation of Acute Pain: A Comparative Study.

Tandon M, Singh A, Saluja V, Dhankhar M, Pandey CK, Jain P - Anesth Pain Med (2016)

Bottom Line: There were 25 disagreements in 8 patients.The OPS is a good stand-alone pain score and is better than the NRS for defining mild and moderate pain.It may even be used to supplement NRS when it is indicative of mild or moderate pain.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India.

ABSTRACT

Background: Pain scores are used for acute pain management. The assessment of pain by the patient as well as the caregiver can be influenced by a variety of factors. The numeric rating scale (NRS) is widely used due to its easy application. The NRS requires abstract thinking by a patient to assign a score to correctly reflect analgesic needs, and its interpretation is subject to bias.

Objectives: The study was done to validate a 4-point objective pain score (OPS) for the evaluation of acute postoperative pain and its comparison with the NRS.

Patient and methods: A total of 1021 paired readings of the OPS and NRS of 93 patients who underwent laparotomy and used patient-controlled analgesia were evaluated. Acute pain service (APS) personnel recorded the OPS and NRS. Rescue analgesia was divided into two incremental levels (level 1-paracetamol 1 g for NRS 2 - 5 and OPS 3, Level 2-Fentanyl 25 mcg for NRS ≥ 6 and OPS 1 and 2). In cases of disagreement between the two scores, an independent consultant decided the rescue analgesia.

Results: The NRS and OPS agreed across the range of pain. There were 25 disagreements in 8 patients. On 24 occasions, rescue analgesia was increased from level 1 to 2, and one occasion it was decreased from level 2 to 1. On all 25 occasions, the decision to supplement analgesia went in favor of the OPS over the NRS. Besides these 25 disagreements, there were 17 occasions in which observer bias was possible for level 2 rescue analgesia.

Conclusions: The OPS is a good stand-alone pain score and is better than the NRS for defining mild and moderate pain. It may even be used to supplement NRS when it is indicative of mild or moderate pain.

No MeSH data available.


Related in: MedlinePlus

Maximum Corresponding OPS Values Plotted Against NRS ValuesOPS, objective pain score; NRS, numeric rating scale.
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Related In: Results  -  Collection

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fig26036: Maximum Corresponding OPS Values Plotted Against NRS ValuesOPS, objective pain score; NRS, numeric rating scale.

Mentions: In the plot depicting the maximum corresponding OPS values against the observed NRS score, (Figure 4) for an NRS of 0 to 4, the OPS was 4, and for an NRS of 7 or higher, the OPS was 1.


Validation of a New "Objective Pain Score" Vs. "Numeric Rating Scale" For the Evaluation of Acute Pain: A Comparative Study.

Tandon M, Singh A, Saluja V, Dhankhar M, Pandey CK, Jain P - Anesth Pain Med (2016)

Maximum Corresponding OPS Values Plotted Against NRS ValuesOPS, objective pain score; NRS, numeric rating scale.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834447&req=5

fig26036: Maximum Corresponding OPS Values Plotted Against NRS ValuesOPS, objective pain score; NRS, numeric rating scale.
Mentions: In the plot depicting the maximum corresponding OPS values against the observed NRS score, (Figure 4) for an NRS of 0 to 4, the OPS was 4, and for an NRS of 7 or higher, the OPS was 1.

Bottom Line: There were 25 disagreements in 8 patients.The OPS is a good stand-alone pain score and is better than the NRS for defining mild and moderate pain.It may even be used to supplement NRS when it is indicative of mild or moderate pain.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India.

ABSTRACT

Background: Pain scores are used for acute pain management. The assessment of pain by the patient as well as the caregiver can be influenced by a variety of factors. The numeric rating scale (NRS) is widely used due to its easy application. The NRS requires abstract thinking by a patient to assign a score to correctly reflect analgesic needs, and its interpretation is subject to bias.

Objectives: The study was done to validate a 4-point objective pain score (OPS) for the evaluation of acute postoperative pain and its comparison with the NRS.

Patient and methods: A total of 1021 paired readings of the OPS and NRS of 93 patients who underwent laparotomy and used patient-controlled analgesia were evaluated. Acute pain service (APS) personnel recorded the OPS and NRS. Rescue analgesia was divided into two incremental levels (level 1-paracetamol 1 g for NRS 2 - 5 and OPS 3, Level 2-Fentanyl 25 mcg for NRS ≥ 6 and OPS 1 and 2). In cases of disagreement between the two scores, an independent consultant decided the rescue analgesia.

Results: The NRS and OPS agreed across the range of pain. There were 25 disagreements in 8 patients. On 24 occasions, rescue analgesia was increased from level 1 to 2, and one occasion it was decreased from level 2 to 1. On all 25 occasions, the decision to supplement analgesia went in favor of the OPS over the NRS. Besides these 25 disagreements, there were 17 occasions in which observer bias was possible for level 2 rescue analgesia.

Conclusions: The OPS is a good stand-alone pain score and is better than the NRS for defining mild and moderate pain. It may even be used to supplement NRS when it is indicative of mild or moderate pain.

No MeSH data available.


Related in: MedlinePlus