Not really for all, but for the most painful procedures is always trying to make them. This for my experience in pediatrics wards, not in neonatology.

We try to use them in a regular basis, and assess the pain scales together with vital signs in the NICU, but we do not apply the scales for each minor procedure.

We don´t score the neonates but in case of painful procedures  we observe them very closely to start early with painkillers. The mild procedural pain (blood sampling etc) we always try to reduce with non- pharmacologic treatment -oral sucrose,non-nutritive sucking, facilitated tucking.

I wonder if pain scales are reliable methids because they r self-reported. How can we rest assure that the patient understands ? Also, some patients exaggerate their pain. 

YES. Several years ago we introduced in the geriatric rehabilitation wards a daily evaluation of pain which is meassured and recorded together with the other vital signs ( temperature,blood pressure , pulse). It is very usefull , and although based on subjective  report ( Visual Analog Scale ) it gives good indication about  the patient's' condition , the titration of the analgesic  treatment and the intensity  range imposed by the effort of the physical therapy. In a study published a few years ago we demonstrated the positive contribution of the daily pain recording on the rehabilitation process of elderly patients ,.

The answer to your question is yes. I work as a vet anaesthetists and pain specuialist and we tend to pain score our patients before the actual surgery and after...so that we have a base line. One must not forget that pain scales are only there to help or guide the physician and should not replace him/her and a medical judgement. Using pain scale allows you to to objectively judge, assess the efficacy of your treatment. I am currently doing a post doc with University of Edinburgh ain pain and chatting with my human colleagues, it seems they seem to think similarly...

Dear Dr Arthur Leibovitz and Dr Thierry Beths , would you please send me the articles for pain scoring? I am working in Diabetic neuropathy and I want to evaluate the patients' pain before and after using a drug. Would you please let me know your ways of scoring the patients pain?

Thanks a lot

Dear Khojasteh  , following is the reference of my article. It is indexed in PubMed

and is free for downloading from there. If you provide your email address I could send it to you  as a PDF copy.

The Effect of a Pain Management Program on the Rehabilitation of Elderly Patients Following Hip Fracture Surgery

A, Zabari' , E Lubart, , F, dekayser-Ganz, Arthur Leibovitz

IMAJ , 2012:14, 104 - 106

Dear Dr Arthur Leibovitz

Thanks a lot for your kindness.

I could only get the abstract of your paper via pubmed.

I really appreciate if you send the PDF file via my e-amil: [email protected]

Thanks a lot

Sent it . Confirm it has arrived  OK.

Hello Dear

I've got your paper. It was very usefull

Thank a lot

Pain scales are mainly used in research to measure the effect of newer analgesics. Its regular use in clinical setting is limited by its interpersonal and intrapersonal variations. It is futile and frustrating to use in children

Not always.

Mainly before or after significant changes in treatments.

It depends on the context. Differences on pain thresholds rely on ethnics, environmental situations, personal feelings, among other factors. There are different pain-scales, but these are single-dimensional scales that gives you the intensity. It should be used before the procedure and in the follow-up in relation with other factors (blood pressure, pulse, temperature, etc.) If used in the clinical setting must be related with multi-dimentional scales.    

Yes, we always use pain score before and after painful procedure to assess the result of  pain relief. 

I don;t use them ona regular basis, only when I don't have a clear communication with my patient or it's complicated for them to express how they feel. As others have mentioned, scales are mostly used for research purposes or standardized interventions.

There is a excellent position statement paper about procedural pain management which highlights the importance of planned comfort assessment and management.

Czarnecki, M. L., Turner, H. N., Collins, P. M., Doellman, D., Wrona, S., & Reynolds, J. (2011). Procedural Pain Management: A Position Statement with Clinical Practice Recommendations. Pain Management Nursing, 12(2), 95-111.

http://www.sciencedirect.com/science/article/pii/S1524904211000749

Dear Joanne I sent you the article on " Pain management  in elderly patients on rehabilitation  following surgery for hip fracture "  . Please confirm.

Arthur

Thank you Arthur I have received your article. I will read it with interest.

Joanne

Pain scales are mostly used in research cotext and some time in clinical situations as well. There is wide interpersonal and intrapersonal variations in pain perception depending upon ethnic background, gender and age, etc. Genetyping for pain perception is still under research.

Pain scale is usually used during patient's assessment including postoperative & wound assessment and after administration of any pain killer medication or providing non pharmacological nursing procedure that help in minimizing pain. It is used as a base line for future comparison.

So I think  the question was about doing a pain scale for every procedure... I dont htink a pain scale is required for a one off  procedure, - as it is used as a base line and a comparator, to look at what is going on with pain over time , in order to better manage pain.

I use pain scales very often as they are specially useful as comparator patern. It is not that much about registrer an specific pain threshold, but overall a question of an objective quantification of the suggestion. 

In Mongolia we have Pain management guide, which was approved in the Mongolian Ministry of Health and according this guide,  before and after painful procedure for pain management, like epidural catheterization, celyac  block, neurolysis, we have to use pain scale  to assess the result of our procedure and we have to do documentation. 

Dear Juan, In Greece we have both the chance to use a scale from 0 to 10 (0= no pain/ 10= the worst pain ever)So far we are not forced to report on that officially.

In our practice we usually ask them with the 0 to 10 scale,  about their pain before and after treatment...  with some patients i think that the easiest would be the visual scale with a face looking from sad to happy...