Anesthetics, analgesics, & sedatives

 

  • Used for prophylaxis and/or control of ICP and seizures

    • Prevent unnecessary movement, coughing/straining

    • Suppress cerebral metabolism

  • S/E: hTN, ↓ cardiac output, ↑ intrapulm shunting; can cause ↓ CPP

  • Recommendations:

    • High-dose barbiturates to control refractory ↑ ICP (not for prophylaxis)

      • Ensure hemodynamic stability during rx

  • Propofol useful to control ICP

    • Not to improve mortality or 6-month outcomes

    • Caution w/ high doses (PRIS)

 

 

Adapted from Guidelines for the Management of Severe TBI, 4th Ed., September 2016, Brain Trauma Foundation.

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