A patient with head trauma and an elevated ICP is being ventilated postoperatively and shows signs of asynchrony with the mechanical ventilator. The most appropriate medication to sedate this patient is which of the following?
a. Morphine
b. Propofol
c. Propofol and morphine
d. Fentanyl
ANS: C
Propofol and morphine, administered simultaneously, allow for greater control of the ICP than morphine alone. Propofol reduces cerebral blood flow and intracranial pressure, making it a use-ful sedative for neurosurgical patients. In fact, propofol has been shown to be more effective than fentanyl in reducing ICP in patients with traumatic brain injury.
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