Background and aims: Pain assessment is essential for patient care but it is difficult to do when the patient is cognitively compromised. Several non-verbal scales for pain assessment are available, but none of them have a validated Bulgarian-language version. The aim of the study is to evaluate the presence of pain and its influence by using two non-verbal scales translated into Bulgarian.
Methods: For twenty patients, fifteen women and five men, 81 ± 6 year old, with communicative problems due to dementia, are used two scales – Checklist of Non-verbal Pain Indicators (CNPI) and Pain Assessment in Advanced Dementia (PAINAD) Scale. Information on dementia is available in patients' medical records. All patients had a intertrochanteric hip fracture and were proposed for planned operative treatment by metal osteosynthesis. In all patients, surgery was performed under spinal anesthesia. In order to facilitation the positioning a femoral block was performed before anesthesia. Pain assessment was performed twice- before and after the ultrasound guided femoral nerve block. Local anesthetic for both regional techniques is ropivacaine.
Results: The two scales show similar results, with CNPIs being slightly higher in the assessment of the pain before the femoral nerve block. The difference in values is not statistically significant.
Conclusions: Nonverbal scales allow the pain and the effect of her treatment to be assessed. Further studies with more patients and different clinical situations are needed to validate the scales in Bulgarian.

ASSESSEMENT OF PAIN AND ITS INFLUENCE ON ELDERLY DEMENTIA PATIENTS WITH INTERTROCHANTERIC HIP FRACTURE - INITIAL EXPERIENCE WITH BULGARIAN-LANGUAGE VERSION OF TWO NONVERBAL SCALES