Sharlai K. Optimisation of analgosedation in patients with a severe traumatic brain injury.

The research is devoted to the comparative study of the effects of a combination of drugs for analgosedation as a component of intensive care in patients with severe traumatic brain injury in the postoperative period. We examined 80 patients with severe traumatic brain injury after urgent craniotomy. Аn analysis of the effectiveness of use of different schemes of analgosedation in patients with severe traumatic brain injury in a postoperative period was conducted on the basis of the study of the stress indicators of stress reactions: a dynamics of concentration of stress markers (insulin, cortisol, glucose, НOMA index); autoimmune reactions: a dynamics of a concentration of autoantibodies to brain antigens (myelin basic protein, S-100 protein, neurospecific enolase, common cerebral antigen); as well as the rate of restoration of consciousness by the Glasgo coma scale (GCS), a duration of mechanical ventilation and lethality. As a result it was discovered that the addition of dexmedetomidine as a component of analgosedation to morphine and sodium oxybutyrate in the complex of intensive care of severe traumatic brain injury allows accelerating the restoration of consciousness by the GCS, reducing the duration of mechanical ventilation and reducing lethality in patients with severe traumatic brain injury in a postoperative period.