ABSTRACT
This chapter summarizes the role of sedative and analgesic drugs in the management of critically ill patients with traumatic brain injury (TBI), providing an overview of the main benefits from the use of sedatives on the brain metabolism in the intensive care unit (ICU). The main open questions remain whether to sedate and for how long. The use of sedatives should be carefully evaluated, not to harm the patient running into so-called oversedation. Deep sedation is, in fact, associated with increased mortality, prolonged mechanical ventilation, and hospitalization. In this context, TBI patients appear to be an exception because they require, in more severe cases, deep sedation as neuroprotective strategy to lower intracranial pressure (ICP). This section reports the rationale and the main indications for the use of sedation and analgesia in TBI critically ill patients and it reviews the receptors targeted from these drugs with an overview of the main sedatives and analgesics normally used in the ICU.
