Dex vs Sufentanyl on CRP Levels in TBI

Background: Traumatic brain injury (TBI) is the cause of the majority of deaths from long-term trauma and disability worldwide. Anesthesia management in TBI craniotomy requires a specific approach to optimize patient output. Dexmedetomidin is increasingly used for its neuroprotective effects. Objective: To determine the difference in C-Reactive Protein (CRP) levels in TBI patients who were given dexmedetomidin and sufentanyl who underwent craniotomy. Methods: A randomized controlled trial involved postcraniotomy TBI patients at Prof. Dr. Margono Soekarjo Hospital who met the inclusion criteria. Subjects were randomized into an intervention group that received desecedtomidin 0.3 mcg.kg-1.h-1 and a control group that received sufentanyl 0.2 mcg.kgBW-1. CRP levels were measured before, 6 hours, and 24 hours postoperatively using an immunoturbidimetric assay. Results: 50 subjects were randomized into two study groups (n=25). The basic characteristics of the two groups were found to be similar. 6-hour CRP levels (38.37 ± 6.67 vs 46.80 ± 7.50 mg.l-1; p=0.007) and 24 hours postoperatively (36.64 ± 7.26 vs 55.96 ± 6.30 mg.l-1; p<0.001) in the injective group was significantly lower than in the control group. Administration of dsmedetomidin resulted in a lower increase in CRP at each time of measurement compared to controls. Conclusions: Administration of dexmedetomidine showed significantly lower improvement in CRP levels at 6 hours and 24 hours postoperatively compared to the sufentanyl group in TBI patients undergoing craniotomy