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Related Concept Videos

Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A key...

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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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[Sedation in neurointensive care unit].

J-F Payen1, G Francony, C Canet

  • 1Service de réanimation neurochirurgicale, pôle d'anesthésie-réanimation, hôpital Michallon, Grenoble cedex 09, France. jfpayen@ujf-grenoble.fr

Annales Francaises D'Anesthesie Et De Reanimation
|December 1, 2009
PubMed
Summary
This summary is machine-generated.

Sedation in neurointensive care units aims to assess neurological function and prevent further brain injury. Careful selection of sedatives and multimodal monitoring are crucial for managing brain-injured patients.

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Last Updated: Jun 18, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Pharmacology

Context:

  • Neurointensive care units (neuroICU) require distinct sedation strategies compared to general intensive care.
  • Severe brain injuries necessitate specialized approaches to manage neurological function and prevent secondary insults.

Purpose:

  • To outline the unique objectives of sedation in neuroICU, focusing on neurological reassessment and protection of the injured brain.
  • To guide the selection of sedatives and analgesics based on the need for timely neurological evaluation versus long-term management of intracranial pressure.

Summary:

  • Sedation in neuroICU serves dual roles: facilitating neurological assessment and mitigating secondary brain injury by controlling cerebral blood perfusion and intracranial pressure.
  • The choice between short-term (e.g., remifentanil) and long-term (e.g., midazolam, sufentanil) sedatives depends on clinical needs.
  • Multimodal monitoring, including intracranial pressure, transcranial Doppler, brain tissue oxygen tension, and imaging, is essential when clinical assessment is limited.

Impact:

  • Optimized sedation protocols can improve patient outcomes by enabling accurate neurological assessment and effective management of intracranial pressure.
  • This approach supports evidence-based decision-making in the complex care of patients with severe brain injuries.
  • Understanding the nuances of neurosedation is vital for clinicians managing critically ill neurological patients.