Effect of nursing implemented sedation and pain protocol on the level of sedation, pain and amount of sedative and analgesic drugs use among opium addicted critically ill patients Rafiei Hossein1, Ahmadinejad Mehdi2, Amiri Masoud3, Abdar Mohammad Esmaeili4,* 1Department of Intensive and Critical Care, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran 2Department of Critical Care, School of Medicine, Kerman Medical University, Kerman, Iran 3Social Health Determinants Research Center and Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran 4Department of Critical Care, School of Nursing, Kerman Medical University, Kerman, Iran *Corresponding Author Email: mesmaeli87@gmail.com
Online published on 5 February, 2014. Abstract Background and Aim Control of pain and sedation in addicted critically ill patients could be different from other admitted patients to intensive care unit (ICU). This study aimed to assess the effect of nursing implemented sedation and pain protocol on the level of sedation, pain and amount of sedative and analgesic drugs use in opium addicted critically ill patients. Methods In a prospective, randomized, controlled trial from September 2011 to June 2012, this study has been conducted in Kerman, Iran. We randomly assigned 37 addicted mechanically ventilated patients who admitted to ICU in two groups; while in intervention group (group I), patients sedated using sedation and pain protocol, in control group (group II), addicted patients received usual, none protocol directed sedation and pain. Using Richmond Agitation Sedation Scale (RASS) and behavioral pain scale (BPS), the level of sedation and pain of patients was assessed in the time of ICU admission and every 4 hours for the first 2 days. Dosage of sedative and analgesic medications used (Morphine and Midazolam) was recorded in special chart every 6 hours by researcher during this period. Finding Mean score of the RASS in time of ICU admission was -1.74±1.1 in group I and -1.81±1.1 in group II. During hospitalization in ICU, score of this scale reached up to -1.10±1.0 in group I and -1.63±1.1 in group II. In the time of ICU admission, mean of BPS in patients in group I and II were 7.9±1.3 and 8.0±1.6, respectively. During ICU stay, score of this scale reached to 5.8±1.6 in group I and 6.9±2.1 in group II. In addition, our results showed that group I patients have received less amount of Morphine and Midazolam in comparison with patients in group II. Conclusion Our results suggested that using nursing implemented sedation and pain protocol for opium addicted critically ill, could lead to experience better sedation and lower level of pain as well as decreasing amount of sedative and analgesics drugs use with implementation of protocol. Top Keywords Opium addicted patient, Nurse, Protocol, Sedation, Pain, ICU. Top |