Expert: Ronald Levy, M.D. - 4/18/2011

Question
My uncle had a brain injury and has a bruise on his brain stem and somewhere else in the brain.  He has had problems with ICP being too high and was given a paralytic and heavily sedated to keep him from moving to try to control the pressure.  He was on this for two full days. He is now off of them, but still sedated. How long might it be before we should expect to see some form of voluntary movement?  He is still on vent and is trying to breath over the vent somewhat. He is also having shivers at times. However, he hasn't moved his body any other way.I guess what I really want to know is, how long before we worry that he hasn't had movement?

Answer
It is difficult to say without knowing more about the injury. Did they put him in a barbiturate coma? Was he heavily sedated and paralyzed for a long time. In both of these cases, it can often take days to "wake up" and depending on how sedated they keep him, you may not know for a while. Your surgeons would be a better judge of when no movement should be a concern for you.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston