Cerebral edema and increased intracranial pressure are of the major consequences of traumatic brain injury that affects the outcome. The aim of this study is to assess the efficacy of dexmedetomidine as an adjunct to conventional sedative therapy (propofol) compared to conventional sedative therapy alone in patients with traumatic brain injury, as regards its effects on hemodynamics and intracranial pressure. This prospective randomized controlled clinical trial with 60 agitated and restless traumatic brain-injured patients was performed between May 2013 and May 2017. Patients who required mechanical ventilation, Glasgow coma scale (GCS) < 8, or hemodynamically instable were excluded. Patients were randomized into three equal groups: dexmedetomidine was infused in a dose of 0.5 μg/kg/h for 48 h in the first group, propofol 1% was infused in a dose of 4 mg/kg/h for 48 h in the second group, and dexmedetomidine was infused in a dose of 0.2 μg/kg/h and propofol was infused in a dose of 2 mg/kg/h for 48 h in the third group. ICP and CPP excursions and complications were assessed in the first 48 h. The number of ICP and CPP excursions per day was not significantly different between the three groups. Tachycardia, bradycardia, and hypertension in the three groups were statistically insignificant. As regards hypotension, there was a statistically significant difference between the three studied groups. Dexmedetomidine or its combination with propofol is as effective as propofol alone in TBI; all alternatives are equal as regards the degree of sedation, effect on intracranial pressure, and cerebral perfusion pressure. The incidence of complications does not vary greatly between all groups. 17200257 registered 5/2013

中文翻译：

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右美托咪定与丙泊酚在颅脑外伤中的作用：某些血液动力学和颅内压变化的评估

脑水肿和颅内压增高是影响结果的外伤性脑损伤的主要后果。这项研究的目的是评估右美托咪定作为创伤性脑损伤患者的常规镇静疗法（丙泊酚）的辅助疗法与单独的常规镇静疗法相比的功效，有关其对血流动力学和颅内压的影响。在2013年5月至2017年5月之间进行了这项前瞻性随机对照临床试验，共60例躁动不安的颅脑外伤患者。需要机械通气，格拉斯哥昏迷评分（GCS）<8或血液动力学不稳定的患者被排除在外。将患者随机分为三组：第一组右美托咪定以0.5μg/ kg / h的剂量输注48小时，在第二组中，以4 mg / kg / h的剂量输注1％的异丙酚48小时，以0.2μg/ kg / h的剂量输注右美托咪定，以2 mg / kg / h的剂量输注丙泊酚h在第三组中持续48 h。在最初的48小时内评估了ICP和CPP的偏移和并发症。三组之间每天的ICP和CPP游览次数没有显着差异。三组的心动过速，心动过缓和高血压在统计学上无统计学意义。至于低血压，三个研究组之间存在统计学差异。右美托咪定或其与丙泊酚的组合与TBI中单独的丙泊酚一样有效。在镇静程度，对颅内压的影响和脑灌注压方面，所有其他选择均相同。各组之间并发症的发生率差异不大。17200257注册于5/2013