Pain practice : the official journal of World Institute of Pain
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Pain assessment in Intensive Care Units (ICU) can be performed based on validated instruments as the Behavioral Pain Scale (BPS). Despite the existence of this clinical score, there is no Brazilian version of it to assess critically ill patients. This study aimed to translate the BPS into Brazilian Portuguese, verify its psychometric properties (reliability, validity, and responsiveness) and the correlation between pain measured and heart rate (HR), blood pressure (BP), Ramsay, and RASS scores. ⋯ Brazilian BPS has high responsiveness and capacity to detect pain intensity in different situations in the ICU routine. This preliminary study proved the feasibility and importance of valid this scale in Brazil in order to improve critically ill patients care.
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There is very strong evidence for the efficacy of transforaminal epidural steroid injection (TFESI) in relieving lumbar radicular pain due to a herniated disk. However, case studies have documented paralysis as a potential complication from this approach as the artery of Adamkiewicz may traverse within the subpedicular "safe triangle." Kambin's retrodiscal approach has been postulated as a safe means to the transforaminal approach to avoid the artery of Adamkiewicz. ⋯ Kambin's approach is at the level of the intervertebral disk and may increase the incidence of intradiscal needle entry and injection.