Sedative for traumatic brain injury

Analgesics and sedatives are frequently used in the treatment of acute brain injury and subsequent brain swelling. Most agents act on specific receptors to modulate neuronal activity, which is normally involved in feedback loops that direct system building and maintenance.

The routine use of sedatives and paralytics in neurotrauma patients may lead to a higher incidence of pneumonia, longer ICU stays, and possibly sepsis ¹⁾.

These agents also impair the neurologic assessment ^{2) 3)}. Use should, therefore, be reserved for cases with clinical evidence of intracranial hypertension, for intubation, or where use is necessary for transport or to permit evaluation of the patient (e.g. to get a combative patient to hold still for a CT scan) ⁴⁾.

Level III: sedation and neuromuscular blockade (NMB) can be helpful for transporting the head-injured patient, but they interfere with the neuro exam

Level III: N M B should be used when sedation alone is inadequate

The routine use of sedatives and paralytics in neurotrauma patients may lead to a higher incidence of pneumonia, longer ICU stays, and possibly sepsis.

These agents also impair neurologic assessment.

Use should, therefore, be reserved for cases with clinical evidence of intracranial hypertension, for intubation, or where use is necessary for transport or to permit evaluation of the patient (e.g. to get a combative patient to hold still for a CT scan).