• Xuemin Wang, Junhui Ji, Liang Fen, and Aizhong Wang.
• Intensive Care Unit, Shanghai Sixth People's Hospital, Medical College of Shanghai Jiaotong University , Shanghai , PR China .
• Brain Inj. 2013 Jan 1;27(13-14):1617-22.

Study ObjectiveTo examine the effect of dexmedetomidine on CBF in critical ill patients with or without TBI.Research DesignProspective controlled trial (ISRCTN57998533).MethodsFifteen patients without TBI and 20 patients with TBI with a Glasgow Coma Scale score of 4-14 were assigned to CON or TBI groups, respectively. All patients received 1 μg kg(-1) dexmedetomidine infused over 10 minutes, followed by a 0.4 μg kg(-1)h(-1) continuous infusion for 60 minutes. Blood pressure was maintained at the pre-sedation level with dopamine for all patients. The CBF and cerebral metabolic rate equivalent (CMRe) were measured before sedation and 70 minutes after dexmedetomidine administration.ResultsDexmedetomidine administration significantly decreased CBF in patients of the CON group (difference = 3.3 ml s(-1), 95% confidence interval [CI] = 0.92-5.7 ml s(-1), p = 0.008), without altering the CMRe and CMRe/CBF ratio. The dexmedetomidine-induced change of CBF, CMRe and CMRe/CBF was not significant in the TBI group. The percentage of CBF reduction was greater in the CON group than in the TBI group (difference = 13.9%, 95% CI = 5.5-22.2%, p = 0.002).ConclusionsDexmedetomidine may be used in patients with TBI without risk of affecting brain oxygenation.

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