[Which sedation scale should be used in the paediatric intensive care unit? A comparative prospective study].
OBJECTIVE
To compare pain and sedation assessments by nurses undertaken with the Objective Pain Scale (OPS) and a Visual Analogue Scale (VAS) to the current reference scale for paediatric intensive care that is the COMFORT scale. To compare the unmodified COMFORT scale to a COMFORT "behaviour" scale which does not include physiologic items. To evaluate the ease of use of these scales.


METHODS
This prospective observational comparative study was carried out in children aged 1 year or older who were admitted in an intensive care unit. At 2 to 3 time points within 24 hours, a pain sedation assessment was carried out by the nurse in charge of the child with COMFORT scale, OPS and VAS. Correlation tests were used to compare the scores of each scale.


RESULTS
Nurses recorded 55 assessments in 20 children. Correlation studies showed a poor correlation between OPS, VAS and the COMFORT scale (Spearman's r=0.54 and 0.53 respectively) and a strong correlation between the COMFORT scale and the COMFORT "behaviour" scale (Spearman's r=0.96). The COMFORT behaviour scale was the most frequently fully completed scale.


CONCLUSIONS
Among the 3 scales compared to the COMFORT scale in this study, the COMFORT "behaviour" scale was the only one to show a strong correlation and it also seemed to be the easiest to use.
Nolent
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Réanimation néonatale et pédiatrique, hôpital d'enfants Armand-Trousseau, Assistance publique-Hôpitaux de Paris, 26, avenue du Docteur-Netter, 75571 Paris cedex 12, France. paul.nolent@trs.ap-hop-paris.fr
Nanquette
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Carbajal
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Renolleau
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D000293:Adolescent; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016292:Procedural Sedation / Q000145:classification*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires