New trends, such as inhalative sedation or ketamine, are beginning to garner moreattention References 1 Oddo M et al. Optimizing sedation in patients with acute brain injury. Critical Care 2016;20:128. 2 Badenes R, De Fez M. Sedation in neurocritical units. In Khan Z (ed): Challenging Topics in Neuroanesthesia and Neurocritical Care. Springer International Publishing Switzerland 2017; 259–74. 3 Brummel NE, Girard. TD. Preventing delirium in the intensive care unit. Crit Care Clin 2013:29:51–65. 4 Otterspoor LC, Kalkman CJ, Cremer OL. Update on the propofol infusión syndrome in ICU management on patients with head injury. Curr Opin Anaesthesiol 2008;21:544–51. 5 Smith HA et al. Delirium: an emerging frontier in the management of critically ill children. Crit Care Clin 2009;25:593–614. 6 Kress JP et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342:1471–7. 7 Hogarth DK, Hall J. Management of sedation in mechanically ventilated patients. Curr Opin Crit Care 2004;10:40–6. 8 DeJonge B et al. Using and understanding sedation scoring systems: a systematic review. Intensive Care Med 2000;26: 275–86. 9 Schnakers C et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain 2010;148:215–9. 10 Riess ML et al. Sedation assessment in critically ill patients with bispectral index. Eur J Anesthesiol 2002;19:18–22. 11 Deogaonkar A et al. Bispectral index monitoring correlates with sedation scales in brain- injured patients. Crit Care Med 2004;32:2403–6. 12 Ogilvie MP, Pereire BM, Ryan ML, et al. Bispectral index to monitor propofol sedation in trauma patients. J Trauma 2011;71:1415–21. 13 Skoglund K et al. The neurological wake up test increases stress hormone levels in patients with severe traumatic brain injury. Crit Care Med 2012;40:216–22. 14 Burry L et al. Daily sedation interruption versus no daily sedation interruption for critically ill adults patients requi ring invasive mechanical ventilation. Cochrane Database Syst Rev 2014;7:CD009176. 15 Heibok R et al. Effects of the neurological wake-up test on clinical examination, intrancranial pressure, brain metabolism and brain tissue oxygenation in severely brain-injured patients. Crit Care 2012;16:R226. 16 Penson RT et al. Randomized placebo-controlled trial to the activity of the morphine glucuronides. Clin Pharmacol Ther 2000;68:667–76. 17 Ickx B et al. Propofol infusion for induction and maintenance of anaesthesia in patients with end- stage real disease. Br J Anaesth 1998;81:854–60. 18 Hiraoka H et al. Changes in drug plasma concentrations of an extensively bound and highly extracted drug, propofol, in response to altered plasma binding. Clin Pharmacol Ther 2004;75:324–30. 19 Servin F et al. Pharmacokinetics of propofol administered by continuous infusion in patients with cirrosis. Preliminary results. Anaesthesia 1988;43:23–4. 20 Pentikainen PJ et al. Pharmacokinetics of midazolam following intravenous and oral administration in patients with chronic liver disease and in healthy subjects. J Clin Pharmacol 1989;29:272–7. 21 Chauvin M et al. Sufentanil pharmacokinetics in patients with cirrhosis. Anesth Analg 1989;68:1–4. 22 Mazoit JX et al. Pharmacokinetics of unchanged morphine in normal and cirrhotic subjects. Anesth Analg 1987;66:296–8. 23 Skoglund K, Enblad P, Marklund N. Effects of the neurological wake up test in intracranial pressure and cerebral perfusion pressure in brain injured patients. Neurocrit Care 2009;11:135–42. 24 Citerio G, Cormio M. Sedation in neurointensive care: advances in understanding and practice. Curr Opin Crit Care 2003;9:120–6. 25 Barr J et al. Propofol dosing regimens for ICU sedation based upon an integrated pharmacikenetic- pharmacodynamic model. Anesthesiology 2001;95:324–33. 26 Oshima T, Karasawa F, Satoh T. Effects of propofol on cerebral blood flow and the metabolic rate of oxygen in humans. Acta Anesthesiol Scand 2002;46:831–5. 27 Engelhard K, Werner C. Inhalational or intravenous anesthetics for craniotomies? Pro inhalational. Curr Opin Anaesthesiol 2006;19:504–8. 28 Trescot AM et al. Opioid pharmacology. Pain Physicia 2008;11: S133–53. 29 Weinbroum AA et al. Midazolam versus propofol for long-term sedation in the ICU: a randomized prospective comparison. Intensive Care Med 1997;23:1258–63. 30 Power KN et al. Propofol treatment in adult refractory status epilecpticus. Mortality risk and outcome. Epilepsy Res 2011;94:53–60. 31 Meierkord H et al. European Federation of Neurological Societies. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol 2010;17:348–55. 32 Marik PE, Varon J. The management of status epilepticus. Chest 2004;126:582–91. 33 Ebert TJ et al. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology1992;76:725–33. 34 Gonzalez-Correa JA et al. Effects of propofol on the leukocyte nitric oxide pathway: in vitro and ex vivo studies in surgical patients. Naunyn Schmiedeberg’s Arch Pharmacol 2008;376:331–9. 35 Dorsout MF et al. Role of propofol and its solvent, intralipid, in nitric oxide induced peripherial vasodilation in dogs. Br J Anesth 2002;89:492–8. 36 Samain E et al. The effect of propofol on angiotensin II-induced Ca 2(+) mobilization in aortic smooth muscle cells from normotensive and hypertensive rats. Anesth Analg 2009;90:546–52. 37 Hutchens MP, Memtsoudis S, Sadovnikoff N. Propofol for sedation in neurointensive care. Neurocrit Care 2006;4:54–62. 38 Roberts DJ et al. Sedation for critically ill adults with severe traumatic brain injury: a systematic review of randomized 13 HHE 2018 | hospitalhealthcare.com controlled trials. Cric Care Med 2011;39:2743–51. 39 Peeters MY et al. Diseases severity is a major determinant for the pharmacodynamics of propofol in critically ill patients. Clin Pharmacol Ther 2008;83:443–51. 40 Karabinis A et al. Safety and efficacy of analgesia-based sedation with remifentanil versus standard hypotic-based regimens in intesive care patients with brain injuries: a randomised, controlled trial. Crit Care 2004;8:R268–80. 41 Hanley DF, Pozo M. Treatment of status epilepticus with midazolam in the critical care setting. Int J Clin Pract 2000;54: 30–5. 42 Walder B, Tramer MR, Seeck M. Seizure-like phenomena and propofol : a systematic review. Neurology 2002;58:1327–32. 43 Bauer TM et al. Prolonged sedation due to accumulation of conjugated metabolites of midazolam. Lancet 1995;346: 145–7. 44 Grof TM, Bledsoe KA. Evaluating the use of dexmedetomidine in neurocritical care patients. Neurocrit Care 2010;12:356–61. 45 Chen HI et al. Barbiturate infusion for intractable intracranial hypertension and its effect on brain oxygenation. Neurosurgery 2008;63:880–6. 46 Marshall GT et al. Pentobarbital come for refractory intra-cranial hypertension after severe traumatic brain injury: mortality predictions and one-year outcomes in 55 patients. J Trauma 2010;69:275–83. 47 Yahwak JA et al. Determination of a lorazepam dose threshold for using the osmol gap to monitor the propylene glycol toxicity. Pharmacotherapy 2008;28:984–91. 48 Jakob SM et al. Dexmedetomidine vs. midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 2012;307:1151–60. 49 Erdman M et al. A comparison of severe hemodynamic disturbances between dexmedetomidine and propofol for sedation in neurocritical care patients. Crit Care Med 2014;42(7):1696–702. 50 Riker RR et al. SEDCOM (Safety and Efficacy of Dexmedetomidine Compared with Midazolam) Study Group: Dexmedetomidine vs. midazolam for sedation of critically ill patients: a randomized trial. JAMA 2009;301:489–99. 51 Jakob SM et al. Dexmedetomidine for long- term sedation investigators: Dexmedetomidine vs. midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 2012;307:1151–60. 52 Martin J et al. Evidence and consensus-based German guidelines for the management of analgesia, sedation and de lirium in intensive care-short versión. Ger Med Sci 2010:8;Doc02. 53 Millane TA, Bennet E, Grounds RM. Isoflurane and propofol for long-term sedation in the intensive care unit a crossover study. Anaesthesia 1992;47: 768–74. 54 Spencer EM, Willats SM. Isoflurane for prolonged sedation in the intensive care unit: efficacy and safety. Intensive Care Med 1992;18:415–21. 55 Meiser A et al. Desflurane compared with propofol for postoperative sedation in the intensive care unit. Br J Anaesth 2003;90:273–80. 56 Halpenny D. Sevoflurane sedation. Can J Anaesth 2000;47:193–4. 57 Ibrahim AE et al. Speed of recovery and side-effect profile of sevoflurane sedation compared with midazolam. Anesthesiology 2001;94:87–94. 58 Kong KL, Willats SM, Prys- Roberts C. Isoflurane compared with midazolam for sedation in the intensive care unti. BMJ 1989:298:1277–80. 59 Kalenka A, Gross B, Isoflurane MH. Anesthesia elicits protein pattern changes in rat hippocampus. J Neurosurg Anesthesiol 2010;22:144–54. 60 Tanzi RE, Bertram L. Twenty years of the Alzheimer´s disease amyloid hypothesis: a genetic perspective. Cell 2005;120:545–55. 61 Selkoe DJ. Alzheimer`s disease: genes, proteins and therapy. Physiol Rev 2001;81:741–66. 62 Eckenhoff RG et al. Inhaled anesthetic enhancement of amyloid-beta oligomerization and cytotoxicity. Anesthesiology 2004;101:703–9. 63 Xie Z et al. The common inhalation anesthetic isoflurane induces apoptosis and increases amyloid beta protein levels. Anesthesiology 2006;104:988–94. 64 Lee JJ, Li L, Jung HH, Zuo Z. Postconditioning with isoflurane reduced ischemia-induced brain injury in rats. Anesthesiology 2008;108:1055–62. 65 Xie Z et al. The inhalation anesthetic isoflurane induces a vicious cycle of apoptosis and amyloid beta-protein accumulation. J Neurosci 2007;27:1247–54. 66 Purruker JC, Renzland J, Uhlmann L. Volatile sedation with sevoflurane in intensive care patients with acute stroke or subarachnoid haemorrhage using AnaConDa®: an observational study. Br J Anaesth 2015;114: 934–43. 67 White PF, Way WL, Trevor AJ. Ketamine – its pharmacology and therapeutic uses. Anesthesiology 1982;56:119–36. 68 Zeiler FA et al. The ketamine effect on intracranieal pressure in nontraumatic neurological illness. J Crit Care 2014;29:1096–106. 69 Himmelseher S, Durieux ME. Revising a dogma: ketamine for patients with neurological injury? Anesth Analg 2005;101:524–34.