Pain assessment tools in cardiac surgery patients, challenges and perspectives: A review article

Introduction: Patients who undergo cardiac surgery stay in intensive care for the first hours or days after their operation and experience severe pain. Several pain assessment tools have been used in cardiac surgery patients, although none is especially designed for this subpopulation of patients.

Purpose: This narrative review explores the existing observational and behavioral tools for assessment of pain in adult cardio surgical patients 

Methods: A literature review was conducted using the international databases Medline/PubMed, Scopus and Google Scholar. Only quantitative studies published in English language journals were included.

Results:  The following pain assessment tools have been used in cardiac surgery patients in ICU: The Behavioral Pain Scale (BPS),Critical-Care Pain Observation Tool (CPOT),Non-Verbal Pain Scale (NVPS), Non-Verbal Pain Assessment Tool (NPAT), Faces, Legs, Activity, Cry and Consolability Scale (FLACC), Visual Analogue Scales (VAS), Numeric Rating Scale (NRS),  as well as Verbal Descriptor Scale and  its alternative, the Thermometer Pain Scale (TPS).

Conclusions:  There is a scarcity of data on pain assessment of cardiac surgery patients in ICU. The existing pain assessment tools have considerable limitations. The creation of a new tool especially designed for cardiac surgery patients is strongly suggested.