Midazolam is effective in controlling intracranial pressure in severe traumatic brain injury

Abstract

Context: Traumatic brain injuries present a grave public health problem in developing countries. Guidelines suggest that neuromuscular blockade (NMB) should be avoided in severe head injury. Midazolam is an affordable option for sedation when resources are limited. Aims: We proposed to study whether midazolam as a sedative agent in severe head injury achieved adequate control of intracranial pressure (ICP) and reduced the need for NMB. Settings and Design: A prospective observational study was conducted in 96 consecutive patients with severe head injury needing ventilation in the neurosurgical intensive care unit (ICU) of our hospital. Subjects and Methods: A modification of “Guidelines for the management of severe head injury, Brain Trauma Foundation” was used to control ICP in these patients. A ventricular catheter was inserted for ICP monitoring and an ICP