A large ICU cohort found concurrent coded sedation and analgesia on most paralysis days. Its calendar-day data could not establish continuous coverage or prove awake paralysis.
The study included 363,382 patient-days across 104,984 hospitalizations. Both parenteral sedation and analgesia were coded on 95.1% of included days.
Sedative agents included midazolam, lorazepam, and diazepam among several other drugs. Some days had only sedation, only analgesia, or neither recorded category, with variation across hospitals.
A charge code does not supply the exact administration time, dose, infusion interruption, or depth of sedation. Alternative agents were not fully captured. The authors explicitly cautioned against interpreting the results as evidence of awake paralysis.
For individual review, administration records and monitoring are needed to assess overlap with blockade. The study supports a systems-level description of coded practice, not a finding that a particular patient was conscious, pain-free, or continuously protected merely because a sedative charge appeared that day.
Original analysis of the supplied journal article, identified as PMC12834453.