Choo Yoon-Hee, Seo Youngbeom, Oh Hyuk-Jin
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Neurosurgery, Yeungnam University Hospital, Yeungnam Universtiy College of Medicine, Daegu, Korea.
Korean J Neurotrauma. 2023 May 31;19(2):185-194. doi: 10.13004/kjnt.2023.19.e19. eCollection 2023 Jun.
Traumatic brain injury (TBI) is one of the leading causes of mortality and disability in adults. In cases of severe TBI, preventing secondary brain injury by managing intracranial hypertension during the acute phase is a critical treatment challenge. Among surgical and medical interventions to control intracranial pressure (ICP), deep sedation can provide comfort to patients and directly control ICP by regulating cerebral metabolism. However, insufficient sedation does not achieve the intended treatment goals, and excessive sedation can lead to fatal sedative-related complications. Therefore, it is important to continuously monitor and titrate sedatives by measuring the appropriate depth of sedation. In this review, we discuss the effectiveness of deep sedation, techniques to monitor the depth of sedation, and the clinical use of recommended sedatives, barbiturates, and propofol in TBI.
创伤性脑损伤（TBI）是成人死亡和残疾的主要原因之一。在严重创伤性脑损伤的病例中，在急性期通过控制颅内高压来预防继发性脑损伤是一项关键的治疗挑战。在控制颅内压（ICP）的手术和药物干预措施中，深度镇静可以使患者感到舒适，并通过调节脑代谢直接控制颅内压。然而，镇静不足无法实现预期的治疗目标，而过度镇静可能导致致命的镇静相关并发症。因此，通过测量适当的镇静深度来持续监测和调整镇静剂很重要。在本综述中，我们讨论了深度镇静的有效性、监测镇静深度的技术，以及推荐的镇静剂、巴比妥类药物和丙泊酚在创伤性脑损伤中的临床应用。
