Why is codeine preferred for analgesia in patients with increased ICP?

The preference for codeine in patients with increased intracranial pressure (ICP) is primarily due to its lower tendency to depress respiration significantly compared to stronger opioid analgesics. In cases of elevated ICP, maintaining adequate respiratory function is crucial, as any degree of respiratory depression can exacerbate the condition and lead to further elevations in ICP. Codeine, being a weaker opioid, offers effective pain relief while minimizing the risk of respiratory compromise, making it suitable for this patient population.

Moreover, while sedative effects, onset of action, and medication interactions are important considerations in analgesic selection, they do not directly address the primary concern associated with increased ICP, which is the potential for respiratory depression. By choosing codeine, clinicians can provide analgesia effectively while prioritizing patient safety and stability.