Assessment and detection of pain in noncommunicative severely brain-injured patients

Abstract

Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their feelings and potential perception of pain. However, recent studies suggest that patients in a minimally conscious state can experience pain to some extent. Pain monitoring in these patients is hence of medical and ethical importance. In this article, we will focus on the possible use of behavioral scales for the assessment and detection of pain in noncommunicative patients.

Keywords::

• behavioral scale
• coma
• consciousness
• minimally conscious state
• nociception
• pain
• severe brain injury
• vegetative state

Financial & competing interests disclosure

The authors’ research is funded by the Belgian Fund for Scientific Research (FRS–FNRS), European Commission, James McDonnell Foundation, Mind Science Foundation, French Speaking Community Concerted Research Action (ARC-06/11-340), Fondation Médicale Reine Elisabeth, University of Liège and the CNRS/FNRS-CGRI collaboration funds. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.