Comparative Tolerability of Sedative Agents in Head-Injured Adults

Authors: Urwin, Susan C.¹; Menon, David K.²

Source: Drug Safety, Volume 27, Number 2, 2004 , pp. 107-133(27)

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Abstract:

Sedative agents are widely used in the management of patients with head injury. These drugs can facilitate assisted ventilation and may provide useful reductions in cerebral oxygen demand. However, they may compromise cerebral oxygen delivery via their cardiovascular effects. In addition, individual sedative agents have specific and sometimes serious adverse effects. This review focuses on the different classes of sedative agents used in head injury, with a discussion of their role in the context of clinical pathophysiology. While there is no sedative that has all the desirable characteristics for an agent in this clinical setting, careful titration of dose, combination of agents, and a clear understanding of the pathophysiology and pharmacology of these agents will allow safe sedative administration in head injury.

Keywords: Head injuries, treatment; Benzodiazepines, therapeutic use; Benzodiazepines, adverse reactions; Propofol, adverse reactions; Propofol, therapeutic use; Opioids, therapeutic use; Opioids, adverse reactions; Barbiturates, adverse reactions; Barbiturates, therapeutic use; Ketamine, therapeutic use; Ketamine, adverse reactions; Etomidate, adverse reactions; Etomidate, therapeutic use; Alpha 2 adrenoceptor antagonists, therapeutic use; Alpha 2 adrenoceptor antagonists, adverse reaction; Antipsychotics, adverse reactions; Antipsychotics, therapeutic use

Document Type: Review article

Affiliations: 1: 1 Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom 2: 2 Department of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom

Publication date: 2004-01-01