From: Optimizing sedation in patients with acute brain injury
Indication | First-line sedative | First-line analgesic | Alternatives |
---|---|---|---|
‘Standard’ sedation, no ICP elevation | Propofol | Fentanyl | Sufentanil |
 | Midazolam | Morphine | Remifentanil |
Elevated ICP | Propofol | Fentanyl | Sufentanil |
 | Midazolam | Morphine | Remifentanil |
Targeted temperature management | Propofol | Fentanyl | Sufentanil |
 | Midazolam | Morphine | Remifentanil |
Status epilepticus | Propofol | Fentanyl | Sufentanil |
 | Midazolam | Morphine | Remifentanil |
Liver dysfunction | Propofol | Fentanyl | – |
 |  | Sufentanil |  |
 |  | Remifentanil |  |
Renal dysfunction | Propofol | Remifentanil | – |
Haemodynamic instability | Midazolam | Fentanyl | Ketamine |
Agitation, delirium | α2-agonists | Fentanyl | Antipsychotics |
 |  | Morphine |  |