title: The preventive effect of dexmedetomidine on paroxysmal sympathetic hyperactivity in severe traumatic brain injury patients who have undergone surgery: a retrospective study.
abstract: BACKGROUND
  Paroxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention.
  
  
  METHODS
  Ninety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the "dexmedetomidine group" (admitted from May 2015 to April 2016). The other 40 patients (admitted from October 2014 to May 2015) received other sedations and were referred as the "control group." The two groups were then compared based on their PSH scores and the scores and ratios of those patients who met the criteria of "probable," "possible" and "unlikely" using the PSH assessment measure (PSH-AM) designed by Baguley et al. (2014). The durations of the neurosurgery intensive care unit (NICU) and hospital stays and the Glasgow outcome scale (GOS) values for the two groups were also compared to evaluate the therapeutic effects and the patients' prognosis.
  
  
  RESULTS
  The overall PSH score for the dexmedetomidine group was 5.26 ± 4.66, compared with 8.58 ± 8.09 for the control group. The difference between the two groups' PSH scores was significant (P= 0.017). The score of the patients who met the criterion of "probable" was 18.33 ± 1.53 in the dexmedetomidine group and 22.63 ± 2.97 in the control group, and the difference was statistically significant (P= 0.045). The ratio of patients who were classified as "unlikely" between the two groups was statistically significant (P= 0.028); that is, 42 (84%) in the dexmedetomidine group and 25 (62.5%) in the control group. The differences in NICU, hospital stays and GOS values between the two groups were not significant.
  
  
  CONCLUSIONS
  Dexmedetomidine has a preventive effect on PSH in sTBI patients who have undergone surgery.
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Qilin
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Weiji
authors.initials: W
authors.lastname: Weng
authors.affiliation: Department of Neurosurgery, Rizhao City Hospital of Traditional Chinese Medicine , Rizhao , Shandong Province , China.
authors.forename: Hongpeng
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Feng
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Guoyi
authors.initials: G
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Head Trauma, Shanghai, China.
authors.forename: Jiyao
authors.initials: J
authors.lastname: Jiang
keywords: Dexmedetomidine; Paroxysmal sympathetic hyperactivity; Preventive effect; Prognosis; Traumatic brain injury