{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:00:41Z","timestamp":1778032841881,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,3,7]],"date-time":"2012-03-07T00:00:00Z","timestamp":1331078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 6\u2010month study in the 30\u2010bed intensive care unit (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>) 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 <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ichmond <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>gitation\u2010<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>edation <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cale (<jats:styled-content style=\"fixed-case\">RASS<\/jats:styled-content>) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Before intratracheal suctioning, patients had <jats:styled-content style=\"fixed-case\">RASS<\/jats:styled-content> scores of \u22121.8\u2009\u00b1\u20091.2 (mean\u2009\u00b1\u2009standard deviation; sedation), \u22120.6\u2009\u00b1\u20091.7 (sedation stop), and \u22120.9\u2009\u00b1\u20091.4 (analgesia) (<jats:italic>P<\/jats:italic>\u2009=\u20090.014). Intratracheal suctioning significantly increased <jats:styled-content style=\"fixed-case\">RASS<\/jats:styled-content> during both sedation (to \u22120.6\u2009\u00b1\u20091.7) and sedation stop (to 1.0\u2009\u00b1\u20091.5) (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), but not during analgesia. Systolic blood pressure increased during sedation (by 9\u2009\u00b1\u200910\u2009<jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content>), during sedation stop (by 15\u2009\u00b1\u200917\u2009<jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content>) and during analgesia (by 9\u2009\u00b1\u20094\u2009<jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content>; all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), but diastolic pressure only during sedation and sedation stop (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>'s standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1399-6576.2012.02660.x","type":"journal-article","created":{"date-parts":[[2012,3,7]],"date-time":"2012-03-07T16:10:59Z","timestamp":1331136659000},"page":"645-654","source":"Crossref","is-referenced-by-count":30,"title":["Assessment of pain in sedated and mechanically ventilated patients: an observational study"],"prefix":"10.1111","volume":"56","author":[{"given":"M. \u2010M.","family":"JEITZINER","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine Bern University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"SCHWENDIMANN","sequence":"additional","affiliation":[{"name":"Institute of Nursing Science University of Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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