Assessment of pain in sedated and mechanically ventilated patients: an observational study
Background Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia. Methods A 6‐month study in the 30‐bed intensive care unit (ICU) of a u...
Gespeichert in:
| Veröffentlicht in: | Acta anaesthesiologica Scandinavica 2012-05, Vol.56 (5), p.645-654 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 654 |
|---|---|
| container_issue | 5 |
| container_start_page | 645 |
| container_title | Acta anaesthesiologica Scandinavica |
| container_volume | 56 |
| creator | JEITZINER, M. -M. SCHWENDIMANN, R. HAMERS, J. P. H. ROHRER, O. HANTIKAINEN, V. JAKOB, S. M. |
| description | Background
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia.
Methods
A 6‐month study in the 30‐bed intensive care unit (ICU) of a university hospital examined 21 sedated patients from various diagnostic groups. Hemodynamic and respiratory parameters, pupil size, facial expression, muscle tone, body movement, and the Richmond Agitation‐Sedation Scale (RASS) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.
Results
Before intratracheal suctioning, patients had RASS scores of −1.8 ± 1.2 (mean ± standard deviation; sedation), −0.6 ± 1.7 (sedation stop), and −0.9 ± 1.4 (analgesia) (P = 0.014). Intratracheal suctioning significantly increased RASS during both sedation (to −0.6 ± 1.7) and sedation stop (to 1.0 ± 1.5) (both P |
| doi_str_mv | 10.1111/j.1399-6576.2012.02660.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_993909076</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>993909076</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4640-ce3ec00d969a1377e5a30b415d37b53fae18ab775705da720fe155a8fa54a9ee3</originalsourceid><addsrcrecordid>eNqNkFtv1DAQRi0EokvLX0CREOIpYRzHcYzEw6qCAq2KWoqQeLEmyURkyWWbScruv8fpbheJJyxL9tjn8-UIEUiIpG9vVpFU1oapNmkUg4wjiNMUos0jsThsPBYLAJChliY-Es-YV75UibVPxVEcJ5DIJF2IH0tmYm6pG4O-CtZYd4HvTCWOVAbYlUFLxU_s6gKbZhvcebBu7vfWONa-4reeCvqcabjzK32HTcDjVG5PxJMKG6bn-_FYfPvw_ub0Y3jx5ezT6fIiLJI0gbAgRQVAaVOLUhlDGhXkidSlMrlWFZLMMDdGG9AlmhgqklpjVqFO0BKpY_F6d-566G8n4tG1NRfUNNhRP7GzVlmwYFJPvvyHXPXT4B_MTiZKasggm6lsRxVDzzxQ5dZD3eKwdRLcrN-t3GzZzZbdrN_d63cbH32xv2DKWyoPwQffHni1B5C90GrArqj5L6f9_2JlPPdux_2uG9r-9wPccvl1nvl8uMvXPNLmkMfhl0uNMtp9vzxz1zdZdvX56tKdqz99Eq-Z</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1431508086</pqid></control><display><type>article</type><title>Assessment of pain in sedated and mechanically ventilated patients: an observational study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>JEITZINER, M. -M. ; SCHWENDIMANN, R. ; HAMERS, J. P. H. ; ROHRER, O. ; HANTIKAINEN, V. ; JAKOB, S. M.</creator><creatorcontrib>JEITZINER, M. -M. ; SCHWENDIMANN, R. ; HAMERS, J. P. H. ; ROHRER, O. ; HANTIKAINEN, V. ; JAKOB, S. M.</creatorcontrib><description>Background
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia.
Methods
A 6‐month study in the 30‐bed intensive care unit (ICU) of a university hospital examined 21 sedated patients from various diagnostic groups. Hemodynamic and respiratory parameters, pupil size, facial expression, muscle tone, body movement, and the Richmond Agitation‐Sedation Scale (RASS) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.
Results
Before intratracheal suctioning, patients had RASS scores of −1.8 ± 1.2 (mean ± standard deviation; sedation), −0.6 ± 1.7 (sedation stop), and −0.9 ± 1.4 (analgesia) (P = 0.014). Intratracheal suctioning significantly increased RASS during both sedation (to −0.6 ± 1.7) and sedation stop (to 1.0 ± 1.5) (both P < 0.01), but not during analgesia. Systolic blood pressure increased during sedation (by 9 ± 10 mmHg), during sedation stop (by 15 ± 17 mmHg) and during analgesia (by 9 ± 4 mmHg; all P < 0.01), but diastolic pressure only during sedation and sedation stop (both P < 0.01). Facial expression, body movement, and muscle tone changed significantly during the episodes of intratracheal suctioning. Heart rate, tidal volume, and pupil size remained stable under all conditions.
Conclusions
Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.</description><identifier>ISSN: 0001-5172</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1111/j.1399-6576.2012.02660.x</identifier><identifier>PMID: 22404146</identifier><identifier>CODEN: AANEAB</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analgesics - therapeutic use ; Analgesics, Opioid - therapeutic use ; Analysis of Variance ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Behavior - physiology ; Biological and medical sciences ; Conscious Sedation ; Diazepam ; Facial Expression ; Female ; Fentanyl - therapeutic use ; Hemodynamics - physiology ; Humans ; Hypnotics and Sedatives ; Male ; Medical sciences ; Middle Aged ; Pain - psychology ; Pain Management ; Pain Measurement - methods ; Physical Stimulation ; Propofol ; Psychomotor Agitation - psychology ; Pupil - drug effects ; Respiration, Artificial ; Suction - adverse effects ; Young Adult</subject><ispartof>Acta anaesthesiologica Scandinavica, 2012-05, Vol.56 (5), p.645-654</ispartof><rights>2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation</rights><rights>2015 INIST-CNRS</rights><rights>2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.</rights><rights>Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4640-ce3ec00d969a1377e5a30b415d37b53fae18ab775705da720fe155a8fa54a9ee3</citedby><cites>FETCH-LOGICAL-c4640-ce3ec00d969a1377e5a30b415d37b53fae18ab775705da720fe155a8fa54a9ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1399-6576.2012.02660.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1399-6576.2012.02660.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25720237$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22404146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>JEITZINER, M. -M.</creatorcontrib><creatorcontrib>SCHWENDIMANN, R.</creatorcontrib><creatorcontrib>HAMERS, J. P. H.</creatorcontrib><creatorcontrib>ROHRER, O.</creatorcontrib><creatorcontrib>HANTIKAINEN, V.</creatorcontrib><creatorcontrib>JAKOB, S. M.</creatorcontrib><title>Assessment of pain in sedated and mechanically ventilated patients: an observational study</title><title>Acta anaesthesiologica Scandinavica</title><addtitle>Acta Anaesthesiol Scand</addtitle><description>Background
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia.
Methods
A 6‐month study in the 30‐bed intensive care unit (ICU) of a university hospital examined 21 sedated patients from various diagnostic groups. Hemodynamic and respiratory parameters, pupil size, facial expression, muscle tone, body movement, and the Richmond Agitation‐Sedation Scale (RASS) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.
Results
Before intratracheal suctioning, patients had RASS scores of −1.8 ± 1.2 (mean ± standard deviation; sedation), −0.6 ± 1.7 (sedation stop), and −0.9 ± 1.4 (analgesia) (P = 0.014). Intratracheal suctioning significantly increased RASS during both sedation (to −0.6 ± 1.7) and sedation stop (to 1.0 ± 1.5) (both P < 0.01), but not during analgesia. Systolic blood pressure increased during sedation (by 9 ± 10 mmHg), during sedation stop (by 15 ± 17 mmHg) and during analgesia (by 9 ± 4 mmHg; all P < 0.01), but diastolic pressure only during sedation and sedation stop (both P < 0.01). Facial expression, body movement, and muscle tone changed significantly during the episodes of intratracheal suctioning. Heart rate, tidal volume, and pupil size remained stable under all conditions.
Conclusions
Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics - therapeutic use</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Analysis of Variance</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Behavior - physiology</subject><subject>Biological and medical sciences</subject><subject>Conscious Sedation</subject><subject>Diazepam</subject><subject>Facial Expression</subject><subject>Female</subject><subject>Fentanyl - therapeutic use</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Hypnotics and Sedatives</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pain - psychology</subject><subject>Pain Management</subject><subject>Pain Measurement - methods</subject><subject>Physical Stimulation</subject><subject>Propofol</subject><subject>Psychomotor Agitation - psychology</subject><subject>Pupil - drug effects</subject><subject>Respiration, Artificial</subject><subject>Suction - adverse effects</subject><subject>Young Adult</subject><issn>0001-5172</issn><issn>1399-6576</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtv1DAQRi0EokvLX0CREOIpYRzHcYzEw6qCAq2KWoqQeLEmyURkyWWbScruv8fpbheJJyxL9tjn8-UIEUiIpG9vVpFU1oapNmkUg4wjiNMUos0jsThsPBYLAJChliY-Es-YV75UibVPxVEcJ5DIJF2IH0tmYm6pG4O-CtZYd4HvTCWOVAbYlUFLxU_s6gKbZhvcebBu7vfWONa-4reeCvqcabjzK32HTcDjVG5PxJMKG6bn-_FYfPvw_ub0Y3jx5ezT6fIiLJI0gbAgRQVAaVOLUhlDGhXkidSlMrlWFZLMMDdGG9AlmhgqklpjVqFO0BKpY_F6d-566G8n4tG1NRfUNNhRP7GzVlmwYFJPvvyHXPXT4B_MTiZKasggm6lsRxVDzzxQ5dZD3eKwdRLcrN-t3GzZzZbdrN_d63cbH32xv2DKWyoPwQffHni1B5C90GrArqj5L6f9_2JlPPdux_2uG9r-9wPccvl1nvl8uMvXPNLmkMfhl0uNMtp9vzxz1zdZdvX56tKdqz99Eq-Z</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>JEITZINER, M. -M.</creator><creator>SCHWENDIMANN, R.</creator><creator>HAMERS, J. P. H.</creator><creator>ROHRER, O.</creator><creator>HANTIKAINEN, V.</creator><creator>JAKOB, S. M.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201205</creationdate><title>Assessment of pain in sedated and mechanically ventilated patients: an observational study</title><author>JEITZINER, M. -M. ; SCHWENDIMANN, R. ; HAMERS, J. P. H. ; ROHRER, O. ; HANTIKAINEN, V. ; JAKOB, S. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4640-ce3ec00d969a1377e5a30b415d37b53fae18ab775705da720fe155a8fa54a9ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics - therapeutic use</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Analysis of Variance</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Behavior - physiology</topic><topic>Biological and medical sciences</topic><topic>Conscious Sedation</topic><topic>Diazepam</topic><topic>Facial Expression</topic><topic>Female</topic><topic>Fentanyl - therapeutic use</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Hypnotics and Sedatives</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pain - psychology</topic><topic>Pain Management</topic><topic>Pain Measurement - methods</topic><topic>Physical Stimulation</topic><topic>Propofol</topic><topic>Psychomotor Agitation - psychology</topic><topic>Pupil - drug effects</topic><topic>Respiration, Artificial</topic><topic>Suction - adverse effects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>JEITZINER, M. -M.</creatorcontrib><creatorcontrib>SCHWENDIMANN, R.</creatorcontrib><creatorcontrib>HAMERS, J. P. H.</creatorcontrib><creatorcontrib>ROHRER, O.</creatorcontrib><creatorcontrib>HANTIKAINEN, V.</creatorcontrib><creatorcontrib>JAKOB, S. M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta anaesthesiologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>JEITZINER, M. -M.</au><au>SCHWENDIMANN, R.</au><au>HAMERS, J. P. H.</au><au>ROHRER, O.</au><au>HANTIKAINEN, V.</au><au>JAKOB, S. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of pain in sedated and mechanically ventilated patients: an observational study</atitle><jtitle>Acta anaesthesiologica Scandinavica</jtitle><addtitle>Acta Anaesthesiol Scand</addtitle><date>2012-05</date><risdate>2012</risdate><volume>56</volume><issue>5</issue><spage>645</spage><epage>654</epage><pages>645-654</pages><issn>0001-5172</issn><eissn>1399-6576</eissn><coden>AANEAB</coden><abstract>Background
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia.
Methods
A 6‐month study in the 30‐bed intensive care unit (ICU) of a university hospital examined 21 sedated patients from various diagnostic groups. Hemodynamic and respiratory parameters, pupil size, facial expression, muscle tone, body movement, and the Richmond Agitation‐Sedation Scale (RASS) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.
Results
Before intratracheal suctioning, patients had RASS scores of −1.8 ± 1.2 (mean ± standard deviation; sedation), −0.6 ± 1.7 (sedation stop), and −0.9 ± 1.4 (analgesia) (P = 0.014). Intratracheal suctioning significantly increased RASS during both sedation (to −0.6 ± 1.7) and sedation stop (to 1.0 ± 1.5) (both P < 0.01), but not during analgesia. Systolic blood pressure increased during sedation (by 9 ± 10 mmHg), during sedation stop (by 15 ± 17 mmHg) and during analgesia (by 9 ± 4 mmHg; all P < 0.01), but diastolic pressure only during sedation and sedation stop (both P < 0.01). Facial expression, body movement, and muscle tone changed significantly during the episodes of intratracheal suctioning. Heart rate, tidal volume, and pupil size remained stable under all conditions.
Conclusions
Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>22404146</pmid><doi>10.1111/j.1399-6576.2012.02660.x</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0001-5172 |
| ispartof | Acta anaesthesiologica Scandinavica, 2012-05, Vol.56 (5), p.645-654 |
| issn | 0001-5172 1399-6576 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_993909076 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over Analgesics - therapeutic use Analgesics, Opioid - therapeutic use Analysis of Variance Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Behavior - physiology Biological and medical sciences Conscious Sedation Diazepam Facial Expression Female Fentanyl - therapeutic use Hemodynamics - physiology Humans Hypnotics and Sedatives Male Medical sciences Middle Aged Pain - psychology Pain Management Pain Measurement - methods Physical Stimulation Propofol Psychomotor Agitation - psychology Pupil - drug effects Respiration, Artificial Suction - adverse effects Young Adult |
| title | Assessment of pain in sedated and mechanically ventilated patients: an observational study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T01%3A07%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Assessment%20of%20pain%20in%20sedated%20and%20mechanically%20ventilated%20patients:%20an%20observational%20study&rft.jtitle=Acta%20anaesthesiologica%20Scandinavica&rft.au=JEITZINER,%20M.%20-M.&rft.date=2012-05&rft.volume=56&rft.issue=5&rft.spage=645&rft.epage=654&rft.pages=645-654&rft.issn=0001-5172&rft.eissn=1399-6576&rft.coden=AANEAB&rft_id=info:doi/10.1111/j.1399-6576.2012.02660.x&rft_dat=%3Cproquest_cross%3E993909076%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1431508086&rft_id=info:pmid/22404146&rfr_iscdi=true |