Review Article
Sedation in Traumatic Brain Injury
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Ketamine | Group | Phencyclidine derivative |
| Mechanism of Action/Pharmacodynamics | Competitive NMDA receptor antagonist Interaction with opioid and muscarinic receptors Na+ Channel |
| Effect on ICP | None or decrease |
| Neuroprotective effects | Decreased glutamate |
| Pharmacokinetics | 20% Bioavailability 40% protein bound Distribution 1/2 10 minutes Hepatic metabolism Elimination 1/2 2.5 h |
| Advantages | Preserves MAP and CPP |
| Disadvantages and major side effects | Early studies ↑ICP, ?epileptogenic Hallucinations/Emergence phenomena |
| Dosage | Induction: 2 mg/kg Maintenance: 50 mcg/kg/min |
| Other significant facts | |
| Appropriate uses in TBI | Haemodynamic instability |
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