الفهرس | Only 14 pages are availabe for public view |
Abstract This prospective, randomized, single blinded, controlled study was carried out in Minia University Hospital during the period from January 2020 to July 2022 after obtaining the local ethical committee of faculty of medicine approval (No. 389: 1/2020) and written informed consents were taken from the patient’s first degree relatives . It involved 90 patients of both sexes ,aged between 18 and 60 years old with American Society of Anaesthiologists ( ASA) physical status I and II with isolated moderate traumatic brain injury (GCS between 9 and 12) not in need to mechanical ventilation. The aim of the present study was to compare the effect of propranolol and propranolol& clonidine in moderate traumatic brain . The patients were randomly allocated into three groups each contains (30) patients. group Propranolol (P) (n = 30): patient received propranolol 20 mg tablet in orogastric or nasogastric tube every 12 hours from day of admission within six hours of admission and for 7 days. Doses stopped for HR <60 b.p.m , MAP<60 mmHg. group Propranolol and Clonidine (PC) (n = 30): patient received propranolol 20 mg tablet every 12 hours and 150 µg Clonidine tablet once daily in orogastric or nasogastric tube and within six hours of admission and for 7 days. Doses stopped for HR <60 b.p.m and MAP <60 mmHg. group Control (C) ( n = 30): patient received conventional treatment only without any beta-blocker or alpha 2 agonists. The following variables: heart rate, mean arterial blood pressure, RR,T., GCS, GOS and Intensive care unit length of stay , SOFA score, catecholmines level were recorded and compared between groups. The study demonstrated that: - Improvement of catecholamines level in group PC compared to other groups. - Improvement of GCS ,GOS in group PC & group P faster than group C. - ICU Length of stay was shorter in group PC & group P than group C. - As regard MAP, HR,T., and RR they were high in group C compared with group PC & group P. We concluded that using Propranolol and Clonidine in moderate traumatic brain injury help in improvement of GCS,GOS, catecholamines levels ,SOFA score , MAP,HR,RR,T., and shorten the duration of ICU stay. |