Assessment is the first step in pain sedation and is one of the most important goals in patient care.(Gelinas C, 2007)

 

Since pain is a subjective phenomenon, the most authentic instrument for its assessment is the patient's own report.(Chanques G, 2010)

 

However, due to the effect of sedatives, changes in the level of consciousness,[5] or cognitive disorders,[6] some patients are unable to communicate or report the pain orally.(Pasero C, 2002)

Therefore, the process of assessing pain in these patients is very difficult.(Payen JF, 2001)

 

Studies have shown that in the absence of the patient's own report, changes in the behavioral and physiological indicators are important criteria for the assessment of pain.(Kwekkeboom KL, 2001)

Accordingly, pain assessment scales have improved in the last decades. One of these scales is nonverbal pain scale (NVPS) which was used for the first time in 2003 by Margaret Odhner et al. for the assessment of pain in critical care burn unit patients.Odhner M, 2003)

The scale designed by Odhner had five dimensions: face, activity, guarding, physiological I (including blood pressure, heart rate, and respiratory rate), and physiological II (including dilation of pupils, diaphoretic, flushing, or pallor).(Topolovec-Vranic J, 2013)

Later studies have shown that the autonomic indicator does not have a good correlation with the other dimensions and with the scale as a whole.(Kabes AM, 2009)

For this reason, NVPS was revised by Wegman in 2005.

In the revised version, the autonomic indicators were replaced by “respiratory” assessment.(Wegman DA, 2005)

In the study done by Kabes et al., the superiority of revised-NVPS (R-NVPS) over original-NVPS (O-NVPS) was emphasized..(Kabes AM, 2009)

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From the time of its design to the present, the efficiency of NVPS in different societies and on different samples has been evaluated, and in most cases, its validity and reliability have been confirmed.(Chanques G, 2014)