Comparison of two behavioural pain scales for the assessment of procedural pain: A systematic review.

The review could not combine results statistically because study designs, patients, procedures and timing differed. Included studies were observational, not randomised, and some had small samples. Several studies used before-and-after designs without random assignment, with limited control of confounders. In a study, nurses were not blinded to whether a procedure was painful, and BPS was always completed first, which may have influenced scores. There is no gold standard for pain assessment in patients who cannot self-report, so comparisons to self-report were limited. The search was restricted to certain languages and excluded some publication types, so relevant studies could be missing. Few studies reported confidence intervals, making precision harder to judge.

The authors declared no conflicts of interest.

Do not conclude that using CPOT or BPS reduces pain or improves ICU outcomes. The review tested how well nurses could score pain during procedures, not whether the scales changed treatment or patient recovery.