Citerio Giuseppe, Cormio Manuela
Dipartimento di Anestesia e Rianimazone, Nuovo Ospedale San Gerardo, Monza, Italy.
Curr Opin Crit Care. 2003 Apr;9(2):120-6. doi: 10.1097/00075198-200304000-00007.
To evaluate the rationale and the pharmacologic options for sedating neurointensive care patients.
Sedation is a fundamental element in the neurointensive care unit. Even if the sedative strategy in the neurointensive care unit shares the same general aims with intensive care, the characteristics of the patients in the neurointensive care unit pose other unique challenges and some specific indications. The primary aim of neurointensive care is to maintain adequate cerebral perfusion pressure, to control intracranial pressure, and to maintain an adequate mean arterial pressure. Reducing the brain's metabolic demand is an important treatment strategy, and analgesic and sedative agents are used to prevent undesirable increases in intracranial pressure. There are many different pharmacologic agents available, each with distinct advantages and disadvantages.
The pharmacokinetic and pharmacologic effects of the available sedatives used in neurointensive care patients are reviewed.
评估对神经重症监护患者进行镇静的基本原理及药物选择。
镇静是神经重症监护病房的一项基本要素。即便神经重症监护病房的镇静策略与重症监护有相同的总体目标，但神经重症监护病房患者的特点带来了其他独特挑战及一些特定适应证。神经重症监护的主要目标是维持足够的脑灌注压、控制颅内压并维持足够的平均动脉压。降低大脑的代谢需求是一项重要的治疗策略，镇痛和镇静药物用于防止颅内压出现不良升高。有许多不同的药物可供使用，每种药物都有其独特的优缺点。
对用于神经重症监护患者的现有镇静药物的药代动力学和药理作用进行了综述。
