Analgosedation is a fundamental part of acute brain injury (ABI) treatment guidelines. The goal of therapy in patients with severe brain injury is to avoid secondary insult. Sedation and analgesia is frequently used in neurocritical care both for reduction of pain, anxiety, discomfort, patient–ventilator asynchrony and neuro-specific indications, namely, intracranial pressure (ICP) control, targeted temperature management (TTM), seizure management. In general, analgosedation practices continue to be diverse in view of lack of evidence in this area. Current practice is mainly empirical and may ensue deleterious hemodynamic and other related side effects.
This presentation offers an overview of current analgosedation practices, cerebral physiologic effects of sedatives and analgesics, the pros and cons of each agent, the comparative effects of standard sedatives in patients with ABI, and the emerging role of alternative sedatives, particularly dexmedetomidine and ketamine.
Arfah Hanim (Malaysia)