The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Many patients with a traumatic brain injury (TBI) cannot communicate because of altered level of consciousness. Although observation of pain behaviors (e.g., frowning) is recommended for pain assessment in nonverbal populations, they are attenuated and sometimes even suppressed in patients with TBI receiving high doses of sedatives. This study explored the potential utility of the bilateral bispectral index system (BIS) for pain detection in critically ill adults with TBI and altered level of consciousness. ⋯ Overall, only increases in BIS-R were correlated with participants' pain behaviors and in those with left-sided TBI exclusively. Although further research is needed, our findings support the potential use of the bilateral BIS for pain detection in nonverbal patients with TBI who cannot behaviorally respond to pain, but only when they have a left-sided injury.