Management of Pain & Agitation

• Opiods

• Benzodiazepines

Management of Movement

• Neuromuscular blockade may be required - use only when necessary

Problems:

• Difficult to assess neurologic exam

• Risk of hypotension

Use short acting agents

Decrease Intracranial Pressure:

Do opiods increase CBF and ICP as well as lower MAP and CPP?

Increased ICP with concurrent decreased MAP and CPP has been documented with use of opiods. But, elevation in ICP is transient and there is no resulting ischemia from decreased MAP / CPP.

Albanese et al. (1999) Critical Care Medicine, 27(2)

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