Millions of people in Canada live with moderate to severe pain that interferes with their lives. Céline Gélinas, RN, PhD, internationally recognized pain researcher and Professor in the Ingram School of Nursing, is doing her best to reduce that burden.
Prof. Gélinas is best known for having developed the widely used Critical-Care Pain Observation Tool (CPOT). Available in more than 20 languages, the CPOT, which is used for critically ill patients unable to self-report their pain, has been implemented in several hundred intensive care units worldwide as well as here in Quebec. It is highly valued for its demonstrated high reliability and validity.
Prof. Gélinas recently received a three-year $400K Canadian Institutes of Health Research (CIHR) Project Grant to study chronic pain in ICU patients after discharge.
Patients admitted to the ICU suffer from a critical care condition which requires intensive monitoring and treatment, explains Prof. Gélinas. More than half of them will experience moderate to severe pain during their ICU stay, and more than 25% of ICU survivors live with chronic pain months to years after their discharge – many of whom require long-term use of opioids to control their pain.
“Our goal is to contribute to a better understanding of opioid use in ICU survivors in Quebec, and to improvements in pain management in the recovery process for better prevention of chronic pain and opioid use/misuse,” she says. In addition to Prof. Gélinas, who will serve as Principal Investigator on this study, the project team includes researchers from various disciplines such as nursing, medicine, pharmacy and psychology, as well as people with lived experience of pain.
Prof. Gélinas also recently co-chaired an expert panel that prepared a new edition of best practice guidelines on preventing, assessing and managing pain across the lifespan for the Registered Nurses Association of Ontario. These guidelines were unveiled officially on February 19, 2025. Titled Pain: Prevention, assessment and management (Fourth edition), this evidence-based resource is designed to enhance decision-making for nurses, interprofessional teams, educators, health-service organizations, academic institutions, persons living with pain and their families.
The guidelines cover four main categories: screening and assessment of pain; management of pain; interprofessional practice in pain management; and pain education for students entering health professions as well as healthcare providers. “All individuals living with acute or chronic pain deserve access to person-centered, evidenced-based pain management,” says Prof. Gélinas.
On the education front, Prof. Gélinas teaches pain assessment in the critically ill adult in the nursing curriculum at the ISoN and supervises graduate and postgraduate students/fellows. She also serves as a lecturer for the Graduate Chronic Pain Management Certificate (online) offered by the School of Physical and Occupational Therapy at McGill.
While the nursing perspective is foundational to her research, Prof. Gélinas emphasizes that assessing pain and establishing the best pain management plan involves a collaborative effort. “Every member of the interprofessional team has a role to play, including patients and their family members,” she explains. Additionally, she notes that effective acute pain management may help prevent the development of chronic pain, resulting in better clinical outcomes and cost savings to our embattled healthcare system.
Prof. Gélinas also leads CIHR-funded research on the implementation of a collaborative approach to pain management in Quebec ICU settings and the validation of a multiparameter technology called Nociception Level index (NOL) for ICU pain assessment. The NOL captures various physiologic parameters (e.g., heart rate, pulse wave, skin temperature) simultaneously through a finger probe which, through an algorithm, generates an index value from 0 to 100. Values above 20-25 have been shown to be indicative of the perception and sensation of pain. Given that there is no valid alternative valid measure for ICU patients who are unable to self-report their pain or exhibit behaviors indicative of pain, further research in this area is needed.
“Research is a powerful tool to guide the development of best practice guidelines and policies that improve the lives of populations and advance the nursing discipline,” she concludes.
