Critical Analysis of Sedation and Analgesia in Severe Head Trauma
Abstract Introduction Head injury is a direct determinant of morbidity, disability, and mortality in the young population. Sedatives and analgesics are commonly used in patients with brain injury to retrieve an ICP, CMRO2, and CBF, preserving the cerebral regulation system and self-avoi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2016-04-01
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| Series: | Brazilian Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1582447 |
| _version_ | 1818618121426042880 |
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| author | Nícollas Nunes Rabelo Neiffer Nunes Rabelo Fabio Santana Machado Marcos Augusto Stávale Joaquim Luiz Antônio Araujo Dias Junior Carlos Umberto Pereira |
| author_facet | Nícollas Nunes Rabelo Neiffer Nunes Rabelo Fabio Santana Machado Marcos Augusto Stávale Joaquim Luiz Antônio Araujo Dias Junior Carlos Umberto Pereira |
| author_sort | Nícollas Nunes Rabelo |
| collection | DOAJ |
| description | Abstract
Introduction Head injury is a direct determinant of morbidity, disability, and mortality in the young population. Sedatives and analgesics are commonly used in patients with brain injury to retrieve an ICP, CMRO2, and CBF, preserving the cerebral regulation system and self-avoiding hypotension.
Objective The objective of this paper is to review on this topic, linking the main drugs, side effects, costs, anxiolytic properties, anticonvulsants, and correlating them with complacency and brain metabolism.
Methods We perform a literature review using PubMed database, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and Clinical trials. We selected papers from the period between 1958 and 2014, which totaled 254 papers. Of these, we selected 129 papers based on keywords, inclusion, and exclusion criteria.
Evidence Review The volume of the brain decreases due to dislocation of the CBV out of the skull. The main sedatives and analgesics are propofol, midazolam, etomidate, ketamine, barbiturates, dexedetomedina, morphine, fentanyl, alfentanil, sulfenatil, and remifentanil. We hereby discuss the algorithm for a fast intubation sequence and the algorithm for intracranial hypertension treatment regarding the systematic sedation therapy. A range of sedatives and analgesic agents are available for sedation. Each class has its own positive and negative effects on neurotrauma patients.
Conclusions The correct analysis of sedation and analgesia in neurotrauma, rapid sequence intubation, and management of medications in intracranial hypertension can lead to an ideal management of brain injury. |
| first_indexed | 2024-12-16T17:16:33Z |
| format | Article |
| id | doaj.art-e78beb5285d145fda33c65d22053d831 |
| institution | Directory Open Access Journal |
| issn | 0103-5355 2359-5922 |
| language | English |
| last_indexed | 2024-12-16T17:16:33Z |
| publishDate | 2016-04-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Brazilian Neurosurgery |
| spelling | doaj.art-e78beb5285d145fda33c65d22053d8312022-12-21T22:23:16ZengThieme Revinter Publicações Ltda.Brazilian Neurosurgery0103-53552359-59222016-04-01350213514710.1055/s-0036-1582447Critical Analysis of Sedation and Analgesia in Severe Head TraumaNícollas Nunes Rabelo0Neiffer Nunes Rabelo1Fabio Santana Machado2Marcos Augusto Stávale Joaquim3Luiz Antônio Araujo Dias Junior4Carlos Umberto Pereira5Department of Neurosurgery, Santa Casa Hospital; Ribeirão Preto, São Paulo, BrazilFaculdade Atenas, Paracatu, Minas Gerais, BrazilDepartment of Pathology, Universidade de São Paulo, Neurointensivism, Hospital Sírio Libanês, São Paulo, SP, BrazilDepartment of Neurosurgery, Universidade de São Paulo, Neuro-oncology and Neurointensivism, Hospital Sírio Libanês, São Paulo, SP, BrazilDepartment of Neurosurgery, Santa Casa Hospital, Ribeirão Preto, São Paulo, BrazilDepartment of Neurosurgery of FBHC and Neurosurgery Service, Aracaju, Sergipe, BrazilAbstract Introduction Head injury is a direct determinant of morbidity, disability, and mortality in the young population. Sedatives and analgesics are commonly used in patients with brain injury to retrieve an ICP, CMRO2, and CBF, preserving the cerebral regulation system and self-avoiding hypotension. Objective The objective of this paper is to review on this topic, linking the main drugs, side effects, costs, anxiolytic properties, anticonvulsants, and correlating them with complacency and brain metabolism. Methods We perform a literature review using PubMed database, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and Clinical trials. We selected papers from the period between 1958 and 2014, which totaled 254 papers. Of these, we selected 129 papers based on keywords, inclusion, and exclusion criteria. Evidence Review The volume of the brain decreases due to dislocation of the CBV out of the skull. The main sedatives and analgesics are propofol, midazolam, etomidate, ketamine, barbiturates, dexedetomedina, morphine, fentanyl, alfentanil, sulfenatil, and remifentanil. We hereby discuss the algorithm for a fast intubation sequence and the algorithm for intracranial hypertension treatment regarding the systematic sedation therapy. A range of sedatives and analgesic agents are available for sedation. Each class has its own positive and negative effects on neurotrauma patients. Conclusions The correct analysis of sedation and analgesia in neurotrauma, rapid sequence intubation, and management of medications in intracranial hypertension can lead to an ideal management of brain injury.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1582447brain injuryintracranial hypertensionsedationanalgesia |
| spellingShingle | Nícollas Nunes Rabelo Neiffer Nunes Rabelo Fabio Santana Machado Marcos Augusto Stávale Joaquim Luiz Antônio Araujo Dias Junior Carlos Umberto Pereira Critical Analysis of Sedation and Analgesia in Severe Head Trauma Brazilian Neurosurgery brain injury intracranial hypertension sedation analgesia |
| title | Critical Analysis of Sedation and Analgesia in Severe Head Trauma |
| title_full | Critical Analysis of Sedation and Analgesia in Severe Head Trauma |
| title_fullStr | Critical Analysis of Sedation and Analgesia in Severe Head Trauma |
| title_full_unstemmed | Critical Analysis of Sedation and Analgesia in Severe Head Trauma |
| title_short | Critical Analysis of Sedation and Analgesia in Severe Head Trauma |
| title_sort | critical analysis of sedation and analgesia in severe head trauma |
| topic | brain injury intracranial hypertension sedation analgesia |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1582447 |
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