Hubungan Nyeri dengan Delirium pada Pasien yang Terintubasi di ICU RSUP Haji Adam Malik Medan

Abstract

Introduction: Pain is generally known as the fifth vital sign, pain can trigger a stress response and stimulate adrenergic-sympathetic activity, causing tachycardia, hypertension, increasing oxygen consumption. Delirium is an acute disturbance of consciousness in the form of inattention or attention, disorganized thoughts and perceptual disturbances that change in a short time. Undiagnosed pain and delirium can lead to increased infection rates, prolonged mechanical ventilation, hemodynamic compromise, delirium, and compromised immunity. Objective: To determine the relationship between pain and delirium in intubated patients in the ICU of HAM Hospital using CPOT in assessing pain and CAM ICU in assessing delirium. Methods: This study used a cross-sectional observational analytic design with a quantitative approach. This study was conducted to determine the relationship between pain and delirium using the CPOT and CAM ICU scales in patients who were intubated at Haji Adam Malik General Hospital Medan during January 2023-February 2023. Results : The relationship between pain and delirium had a P-value of 0.001, the relationship between fentanyl dose and pain in intubated patients had a P-Value = 0.012, a confounding factor for length of stay with pain P-Value = 0.000, a confounding factor for delirium with an Age P-Value of 0.026, delirium with Gender P-Value 0.013, delirium with length of stay P-Value = 0.001, all of these values are P-Value <0.005 which are considered to have a significant relationship. Meanwhile, the relationship between the doses of fentanyl and midazolam between delirium and no delirium had no significant relationship because the P-Value was> 0.05%. Conclusion: There is a significant relationship between pain and delirium (p = 0.001). There is a significant relationship between Fentanyl dosage and pain (P-value = 0.012). There was no significant relationship between fentanyl and midazolam doses and delirium (P-value = 0.500). The confounding factor associated with pain was length of stay p <0.001. The length of stay of patients who experienced the most pain was 0-7 days (85.7%). All confounding factors were associated with delirium. Patients aged 18-35 years (82.4%), female (67.5%) and whose length of stay was 0-7 days (85.7%) had the most delirium.