Patients' perceptions and responses to procedural pain: Results from thunder project II

Kathleen A. Puntillo, Cheri White, Ann Bonham Morris, Sondra T. Perdue, Julie Stanik-Hutt, Carol Lynn Thompson, Lorie Rietman Wild

Research output: Contribution to journalArticlepeer-review


• Background Little is known about the painfulness of procedures commonly performed in acute and critical care settings. • Objective To describe pain associated with turning, wound drain removal, tracheal suctioning, femoral catheter removal, placement of a central venous catheter, and nonburn wound dressing change and frequency of use of analgesics during procedures. • Methods A comparative, descriptive design was used. Numeric rating scales were used to measure pain intensity and procedural distress; word lists, to measure pain quality. • Results Data were obtained from 6201 patients: 176 younger than 18 years and 5957 adults. Mean pain intensity scores for turning and tracheal suctioning were 2.80 and 3.00, respectively (scale, 0-5), for 4-to 7-year-olds and 52.0 and 28.1 (scale, 0-100) for 8-to 12-year-olds. For adolescents, mean pain intensity scores for wound dressing change, turning, tracheal suctioning, and wound drain removal were 5 to 7 (scale, 0-10); mean procedural distress scores were 4.83 to 6.00 (scale, 0-10). In adults, mean pain intensity scores for all procedures were 2.65 to 4.93 (scale, 0-10); mean procedural distress scores were 1.89 to 3.47 (scale, 0-10). The most painful and distressing procedures were turning for adults and wound care for adolescents. Procedural pain was often described as sharp, stinging, stabbing, shooting, and awful. Less than 20% of patients received opiates before procedures. • Conclusions Procedural pain varies considerably and is procedure specific. Because procedures are performed so often, more individualized attention to preparation for and control of procedural pain is warranted.

Original languageEnglish (US)
Pages (from-to)238-251
Number of pages14
JournalAmerican Journal of Critical Care
Issue number4
StatePublished - Jul 1 2001

ASJC Scopus subject areas

  • Critical Care


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