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Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury

Background: Studies have shown that dexmedetomidine improves neurological function. Whether dexmedetomidine reduces mortality or improves quantitative electroencephalography (qEEG) among patients post-craniotomy remains unclear. Methods: This single-center randomized study was conducted prospectivel...

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Autores principales: Huang, Yanxia, Deng, Yunxin, Zhang, Renjing, Meng, Mei, Chen, Dechang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221420/
https://www.ncbi.nlm.nih.gov/pubmed/35741637
http://dx.doi.org/10.3390/brainsci12060752
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author Huang, Yanxia
Deng, Yunxin
Zhang, Renjing
Meng, Mei
Chen, Dechang
author_facet Huang, Yanxia
Deng, Yunxin
Zhang, Renjing
Meng, Mei
Chen, Dechang
author_sort Huang, Yanxia
collection PubMed
description Background: Studies have shown that dexmedetomidine improves neurological function. Whether dexmedetomidine reduces mortality or improves quantitative electroencephalography (qEEG) among patients post-craniotomy remains unclear. Methods: This single-center randomized study was conducted prospectively from 1 January 2019 to 31 December 2020. Patients who were transferred to the ICU after craniotomy within 24 h were included. The analgesic was titrated to a Critical care Pain Observation Tool (CPOT) score ≤2, and the sedative was titrated to a Richmond Agitation–Sedation Scale (RASS) score ≤−3 for at least 24 h. The qEEG signals were collected by four electrodes (F3, T3, F4, and T4 according to the international 10/20 EEG electrode practice). The primary outcome was 28-day mortality and qEEG results on day 1 and day 3 after sedation. Results: One hundred and fifty-one patients were enrolled in this study, of whom 77 were in the dexmedetomidine group and 74 in the midazolam group. No significant difference was found between the two groups in mortality at 28 days (14.3% vs. 24.3%; p = 0.117) as well as in the theta/beta ratio (TBR), the delta/alpha ratio (DAR), and the (delta + theta)/(alpha + beta) ratio (DTABR) between the two groups on day 1 or day 3. However, both the TBR and the DTABR were significantly increased in the dexmedetomidine group. The DTABR in the midazolam group was significantly increased. The DAR was significantly increased on the right side in the dexmedetomidine group (20.4 (11.6–43.3) vs. 35.1 (16.7–65.0), p = 0.006) as well as on both sides in the midazolam group (Left: 19.5 (10.1–35.8) vs. 37.3 (19.3–75.7), p = 0.006; Right: 18.9 (10.1–52.3) vs. 39.8 (17.5–99.9), p = 0.002). Conclusion: Compared with midazolam, dexmedetomidine did not lead to a lower 28-day mortality or better qEEG results in brain injury patients after a craniotomy.
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spelling pubmed-92214202022-06-24 Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury Huang, Yanxia Deng, Yunxin Zhang, Renjing Meng, Mei Chen, Dechang Brain Sci Article Background: Studies have shown that dexmedetomidine improves neurological function. Whether dexmedetomidine reduces mortality or improves quantitative electroencephalography (qEEG) among patients post-craniotomy remains unclear. Methods: This single-center randomized study was conducted prospectively from 1 January 2019 to 31 December 2020. Patients who were transferred to the ICU after craniotomy within 24 h were included. The analgesic was titrated to a Critical care Pain Observation Tool (CPOT) score ≤2, and the sedative was titrated to a Richmond Agitation–Sedation Scale (RASS) score ≤−3 for at least 24 h. The qEEG signals were collected by four electrodes (F3, T3, F4, and T4 according to the international 10/20 EEG electrode practice). The primary outcome was 28-day mortality and qEEG results on day 1 and day 3 after sedation. Results: One hundred and fifty-one patients were enrolled in this study, of whom 77 were in the dexmedetomidine group and 74 in the midazolam group. No significant difference was found between the two groups in mortality at 28 days (14.3% vs. 24.3%; p = 0.117) as well as in the theta/beta ratio (TBR), the delta/alpha ratio (DAR), and the (delta + theta)/(alpha + beta) ratio (DTABR) between the two groups on day 1 or day 3. However, both the TBR and the DTABR were significantly increased in the dexmedetomidine group. The DTABR in the midazolam group was significantly increased. The DAR was significantly increased on the right side in the dexmedetomidine group (20.4 (11.6–43.3) vs. 35.1 (16.7–65.0), p = 0.006) as well as on both sides in the midazolam group (Left: 19.5 (10.1–35.8) vs. 37.3 (19.3–75.7), p = 0.006; Right: 18.9 (10.1–52.3) vs. 39.8 (17.5–99.9), p = 0.002). Conclusion: Compared with midazolam, dexmedetomidine did not lead to a lower 28-day mortality or better qEEG results in brain injury patients after a craniotomy. MDPI 2022-06-08 /pmc/articles/PMC9221420/ /pubmed/35741637 http://dx.doi.org/10.3390/brainsci12060752 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Huang, Yanxia
Deng, Yunxin
Zhang, Renjing
Meng, Mei
Chen, Dechang
Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title_full Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title_fullStr Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title_full_unstemmed Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title_short Comparing the Effect of Dexmedetomidine and Midazolam in Patients with Brain Injury
title_sort comparing the effect of dexmedetomidine and midazolam in patients with brain injury
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221420/
https://www.ncbi.nlm.nih.gov/pubmed/35741637
http://dx.doi.org/10.3390/brainsci12060752
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