Once a head-injured patient is intubated and venti-lated, sedation is routinely commenced. Sedation will
reduce ICP and will help to dampen the effect of any
potential stimuli that may increase ICP.
Sedation canreduce systemic blood pressure, which should be
avoided as this will reduce theCPP.
Hall (1997) discusses that the use of barbiturates in head injury care
is controversial, but they may be useful when ICP remains extensively elevateddespite using other treat-ments.
Allen and Ward (1998) explain that its role in severe head injury is to reduce the cerebral metabolic
rate; however, it needs to be given in large doses
which tends to cause hypotension, and then inotropes
are required to overcome its depressive cardiac effects.