History Detecting discomfort is vital in sedated and ventilated individuals because they are struggling to communicate verbally mechanically. three differing times: 1) baseline (instantly before ICG-001 any unpleasant treatment including tracheal suctioning or changing the patient’s placement) 2 during any unpleasant treatment and 3) 5 minutes after the procedure (recovery time). Results The mean values for CPOT BIS and mean arterial pressure (MAP) scores were significantly different at different times; they were increased during suctioning or changing position and decreased five minutes after these procedures (CPOT: 3.98 ± 1.65 versus 1.31 ± 1.07 respectively (P ≤ 0.0001); BIS: 84.94 ± 10.52 versus 63.48 ± 12.17 respectively (P ≤ 0.0001); MAP: 92.88 ± 15.37 versus 89.77 ± 14.72 respectively (P = 0.003)). Change in heart rate (HR) was not significant over time (95.68 ± 16.78 versus 93.61 ± 16.56 respectively; P = 0.34). CPOT scores were significantly positively correlated with BIS at baseline during painful stimulation and at recovery time but were not correlated with HR or MAP except at baseline. BIS scores were significantly correlated with MAP but not with HR. Conclusions It appears that BIS monitoring can be used for pain assessment along with the CPOT tool ICG-001 in intubated patients and it is much more sensitive than monitoring of hemodynamic changes. BIS monitoring can be used more efficiently in intubated patients under deep sedation in the ICU. Keywords: Bispectral Index Monitoring Pain Assessment Vital Signs Intensive Care Unit Cardiac Surgery 1 Background Control of pain after open-heart surgery in patients in the intensive care unit (ICU) is a major concern of healthcare providers. Pain is usually a subjective and personal experience that affects most body systems and can result in prolonged hospital stays (1-3). Many procedures performed by nurses in the ICU such as patient repositioning catheter and drain removal endotracheal suctioning and wound care have been identified as painful for patients. However verbal communication is altered in patients with endotracheal intubation or a ICG-001 reduced level of consciousness due to sedative or paralyzing drugs; therefore pain assessment in such situations is essential and challenging (4 5 For sufficient discomfort assessment and medicine in intubated or unconscious sufferers some valid observable behavioral scales and physiological indications like the Critical-care discomfort observation device (CPOT) are utilized (6). The CPOT is certainly a feasible easy-to-complete and simple-to-understand device that includes an assessment of four different behaviors (cosmetic expressions body actions muscle stress and compliance using the ventilator for mechanically ventilated sufferers or vocalization for non-intubated sufferers) (7). Yet in some circumstances such as for example when the individual receives high dosages of sedative medications or neuromuscular blockers the usage of CPOT is much less valuable because of inhibition of electric motor function (8). Another criterion utilized to assess discomfort in ICU sufferers is vital symptoms. Although vital symptoms are easily available in the ICU their validity for discomfort assessment isn’t strongly confirmed. Furthermore vital signs aren’t recommended indications for discomfort assessment in non-verbal sufferers predicated on the American culture for discomfort management medical (ASPMN) suggestions (9). Also administration of varied drugs such as for BMP2B example beta-blockers calcium-channel blockers and various other medications that affect blood circulation pressure and heartrate (HR) can modulate the cardiovascular response to discomfort. Alternatively since there is a significant romantic relationship between discomfort as well as the sensory program the cortical arousal response is certainly a known discomfort sign. BIS monitoring can be used for this function being a potential device for the recognition of discomfort (10 11 BIS is certainly a noninvasive technology with the primary reason for quantifying adjustments in the brain’s electrophysiological condition during sedation and anesthesia by calculating different indices like ICG-001 the BIS worth electromyographic (EMG) activity electroencephalographic (EEG) data as well as the thickness spectral array (DSA) (6). 2 Goals The purpose of this research was to judge BIS for discomfort evaluation in sedated and mechanically ventilated adult ICU sufferers after cardiac medical procedures. The CPOT and essential signs such as for example mean arterial pressure (MAP) and HR had been assessed during unpleasant procedures then weighed against each other.