COMPARING THE EFFECT OF DEXMEDETOMIDINE VERSUS HALOPERIDOL IN CONTROLLING AGITATION IN TRAUMATIC BRAIN INJURY

Traumatic brain injury (TBI) is a leading cause of mortality and long-term neurological disability. A considerable risk following TBI is post-traumatic cognitive impairment (agitation), occurring in approximately two-thirds of survivors. The management of post-traumatic agitation in ICU patients remains inadequately defined. Currently, there is limited evidence-based therapeutic intervention that has demonstrated a significant impact on outcomes within this patient population. However, emerging research indicates that certain pharmacological treatments, particularly antipsychotics (haloperidol), and, additionally, medications such as dexmedetomidine, are two commonly utilised medications in clinical practice for this purpose when non-pharmacological approaches prove ineffective in managing agitation.AIM OF THE WORK:The aim of this study was to compare the effect of dexmedetomidine to haloperidol in controlling agitation in TBI patients regarding their impact on hospital mortality and morbidity (resolution of symptoms, need and duration of mechanical ventilation, ICU stay and in-hospital stay).PATIENTS AND METHODS:60 patients were included in a prospective study aged 18–65 with moderate traumatic brain injury (TBI) admitted to the Critical Care Department at Alexandria Main University Hospitals. Eligible patients had a Glasgow Coma Scale (GCS) score of 9–12 and a Richmond Agitation Sedation Scale (RASS) score of +2 to +4. Patients were excluded if they were pregnant, breastfeeding, hypotensive, bradycardic, or allergic to the studied medications.