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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Dec 9, 2025; 14(4): 111787
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111787
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111787
Sedation and analgesia strategies in the neuro intensive care unit
Zachary I Merhavy, Department of Clinical Medicine, Ross University School of Medicine, Pontiac, MI 48341, United States
Tereque Raeburn, Department of Clinical Medicine, St. George’s University, True Blue, Grenada
Gloria M Torres-Ayala, Melissa A McCulloch, Department of Clinical Medicine, University of Medicine and Health Sciences, Basseterre, Saint Kitts and Nevis
Thomas C Varkey, Department of Neurology, University of Arizona College of Medicine, Phoenix, AZ 85004, United States
Author contributions: Merhavy ZI contributed to conceptualization, and critical revisions; Varkey TC contributed to critical revisions; Merhavy ZI, Raeburn T, Torres-Ayala GM, McCulloch MA, Varkey TC contributed to drafting and editing.
Conflict-of-interest statement: All authors affirm that there are no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zachary I Merhavy, Department of Clinical Medicine, Ross University School of Medicine, 44405 Woodward Ave, Pontiac, MI 48341, United States.
Received: July 9, 2025
Revised: July 23, 2025
Accepted: September 12, 2025
Published online: December 9, 2025
Processing time: 142 Days and 17.3 Hours
Revised: July 23, 2025
Accepted: September 12, 2025
Published online: December 9, 2025
Processing time: 142 Days and 17.3 Hours
Core Tip
Core Tip: It can be challenging for providers to manage critically ill patients in the neuro intensive care unit (ICU) due to the many factors hindering their ability to adequately assess the patient, such as altered baseline mental status as well as the addition of analgesics and sedatives. Relying on labs and imaging findings alone are often inadequate to assess patients and these multimodal neuroimaging methods should always be used adjunctively with comprehensive and thorough physical and neurological exams. This paper provides a structured overview of commonly used sedatives in the neuro ICU to assist intensivists in developing more individualized management decisions for each patient in hopes to further improve patient outcomes.