SynthesisNursing in critical care2026
Pain Measurement in Critically Ill Non-Verbal Patients With Brain Injury: A Systematic Review.
Synthesis in Nursing in critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPain management in critically ill patients with brain injury is a clinical and ethical concern in critical care settings that is complicated by altered consciousness and communication barriers.
aimTo identify, synthesise and categorise methods for effective pain assessment in critically ill, non-verbal patients with brain injury in critical care settings.
designA systematic review following PRISMA guidelines, registered in PROSPERO, included 13 articles that examined pain among those patients.
resultsValidated assessment tools, such as the Critical Care Pain Observation Tool and the Behavioural Pain Scale, remain the gold standard for pain assessment in patients with brain injury. The most universal behavioural indicators of pain in these patients are frowning, sudden eye opening and limb flexion. However, behavioural indicators are often blunted by the level of consciousness, sedation or severity of injury. Conversely, physiological parameters lack diagnostic specificity and might be confounded by autonomic nervous system instability or medications. Emerging advanced technologies offer an objective approach to the nociception process.
conclusionClinicians should be cautious while assessing pain in brain-injured patients; a low pain score may be a false negative caused by the inability to react rather than an actual absence of pain. It is recommended to adopt a multi-modal approach for pain assessment in critically ill patients with brain injury. RELEVANCE TO CLINICAL PRACTICE: The findings may inform pain assessment protocols in critically ill non-verbal patients with brain injury, suggesting that using an isolated approach is inadequate and inaccurate.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.