Assessment of pain associated to common invasive procedures and nurse’s opinion

Introduction and aim of the study Invasive diagnostic and therapeutic procedures (IDTP) may be painful and cause physical and emotional discomfort. An observational study was conducted in three medical wards of S. Giovanni Battista Hospital, to a) assess pain and discomfort experienced by patients during IDTPs and nurses’ opinion; b) describe frequency and outcomes of the administration of analgesics and anxiolitics. Methods Pain was assessed with a Numeric Rating Scale (NRS) before and after IDTPs and patients were asked to describe the main causes of pain/discomfort experienced. An anonymous questionnaire was completed by nurses to express their opinion on painfulness and discomfort caused by a list of IDTPs. Mean an DS were calculated for each IDTP and results compared with nurses’ opinion (P<0.05) using Wilcoxon Test. Results Data on 186 patients and 200 IDTPs were collected. The most performed IDTPs were EGDS (18%), blood gas analysis (14%) and colonoscopy (12.5%). The most painful were Bone Marrow Biopsy (BOM) (NRS 7.05) and colonoscopy (NRS 6.44); those more anxiety provoking the BOM (NRS 7.26) and bronchoscopy (NRS 5.09). No analgesic or insufficient dosages were administered before some IDTPs and, for 56% of these, patients would have liked it. Nurses rate patients pain and fear/anxiety significantly higher than what experienced by patients. Conclusion Acute pain, fear and anxiety are poorly controlled during IDTPs; the lack of protocols for pain control may be responsible for the different levels of discomfort experienced.