• Anne Coutaux, Laurence Salomon, Michel Rosenheim, Anne-Sophie Baccard, Catherine Quiertant, Emmanuelle Papy, Thierry Blanchon, Elisabeth Collin, François Cesselin, Michèle Binhas, Pierre Bourgeois, and Pain Committee, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
• Unit of Pain Assessment and Treatment, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie - Paris VI, Paris 75005, France.
• Eur J Pain. 2008 Jan 1;12(1):3-8.

ContextCare-related pain includes pain occurring during transportation, movement, diagnostic imaging, physical examination, or treatment. Its prevalence has never been assessed in a large adult inpatient population.ObjectiveTo identify the procedures likely to induce or increase pain in hospital patients, attempting to separate the most painful from those reported as most frequently inducing pain.DesignA single-day cross-sectional survey conducted in two large French teaching hospitals, including all hospitalized patients, free of communication problems. One third was randomly selected and interviewed about the painful episodes that had occurred or were associated with the procedures performed during the previous two weeks. Patients were interviewed using a structured questionnaire.ResultsSix-hundred-eighty-four patients were randomly selected. Six-hundred-seventy-one painful events were reported in 55% of the patients, with an average of 1.8 events/patient. Fifty-two percent of the painful events were associated with procedures performed by non-medical staff; 38% of the painful episodes occurred during procedures involving vascular puncture and 24% during patients' mobilization. In 57% of painful procedures, pain was rated as severe or extremely severe. The most painful procedures were invasive procedures, other than vascular and non vascular punctures (74% of severe and extremely severe painful episodes). Maximum pain intensity was rated higher for procedures that were repeated than for those experienced only once (62% versus 53%, p=0.02).ConclusionThis survey gives new insight into our daily practice. Proper management of care-related pain should be a major concern of all hospital staff to improve the quality of our health care.

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