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Accurate pain assessment is paramount in critically ill patients. A range of validated tools can be used in different clinical situations. For those able to express themselves, the Numeric Rating Scale (NRS) and the Visual Analogue Scale (VAS) are commonly used. For patients unable to communicate, tools like the Critical-Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS) have been designed. Additionally, physiological signs, including changes in heart rate, blood pressure, and pupil dilation, can offer clues, though they often lack specificity and can be influenced by myriad factors