The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse’s assessment of neonates

Objective:to determine the reliability of an objective measure of pain, agitation and sedation using the neonatal pain, agitation and sedation scale (n-pass) compared with nursing bedside assessment.study design:neonates admitted in neonatal intensive care unit over a 6-month period were eligible. pain and sedation were assessed with n-pass, and a subjective questionnaire was administered to the bedside nurse.result:a total of 218 neonates were eligible (median: gestational age 34.6 weeks, age at assessment 7 days). n-pass pain score correlated significantly with both nurses’ pain score (spearman coefficient (r)=0.37; p<0.001) and agitation score (r=0.56; p<0.001). n-pass sedation score correlated with nurses’ sedation score (r=−0.39; p<0.001). adjusting for gestational age, day of life, intrauterine drug exposure and use of high frequency ventilation only slightly attenuated the correlations (r=0.36, 0.55 and −0.31, respectively).conclusion:the n-pass captures nursing assessment of pain, agitation and sedation in this broad population and provides a quantitative assessment of subjective descriptions that often drives patient therapy.