benzodiazepine in increased icp

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Hi all, I'm a nursing student in my second med surg class and while reading about increased icp I got a bit confused.

In my book it says that benzodiazepines are contraindicated in increased icp because of its hypotensive effect and long half life unless it is used as an adjunct to neuromuscular blocking agents.

While it says that neuromuscular blocking agents are used to paralyze muscles without blocking pain or noxious stimuli, I don't see how it makes benzodiazepine not contraindicated, as it didn't address the hypotensive effect or the long half life (which I presume will interfere with neurologic assessments).

I guess what I'm asking is what makes it ok to use benzodiazepines with neuromuscular blocking agents? Thanks all!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Benzoes without NM blockade not only cause hypotension decreasing the blood circulated to the brain that is already compromised by swelling....but it suppresses respiration increasing the CO2 and there by the ICP can increase.

If you are using a NM blockade and paralyzing the patient they are on a vent and you control the respiration for the patient. Blockade meds are ONLY USED on VENTED patients and because the only act on the muscles (live mind/"dead" body) a long acting Benzo is useful in sedating the paralyzed patient.

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Thank you so much esme! That makes a lot of sense

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