A COMPARATIVE PROSPECTIVE STUDY OF GABAPENTIN'S ROLE IN TRAUMATIC BRAIN INJURY.

Jag Mohan  Kumar; Kunal  Raj; Jay  Prakash; Pradip Kumar  Bhattacharya; Amit  Kumar

doi:10.51168/sjhrafrica.v5i9.1364

Authors

Jag Mohan Kumar Senior Resident, Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
Kunal Raj Senior Resident, Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
Jay Prakash Assistant Professor, Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
Pradip Kumar Bhattacharya HOD, Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
Amit Kumar Senior Resident, Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i9.1364

Keywords:

Traumatic Brain Injury (TBI), Paroxysmal Sympathetic Hyperactivity (PSH), Gabapentin, Secondary Brain Injury

Abstract

Background

Traumatic brain injury (TBI) causes 65% of motor vehicle-related deaths in young individuals. Paradoxical sympathetic hyperactivity is a common and dangerous TBI complication. This study explores the potential of gabapentin to mitigate secondary brain injury and cerebral edema, alongside enhancing Glasgow Coma Scale (GCS) outcomes in TBI patients.

Method

This year-long study included adult ICU patients with moderate to severe GCS scores. Participants were randomly assigned to two groups: the experimental group received 300 mg of gabapentin orally twice a day, whereas the control group received multivitamin tablets. The 2-week treatment regimen includes telephone check-ins for up to 3 months after discharge.

Results

The study analyzed 67 participants, predominantly male (Group I: 79.4%, Group II: 72.73%), with an average age of 36.5 years in Group I and 40.4 years in Group II. Notable Improvements were noted in the experimental group, including a significant increase in GCS change from admission to discharge (53% in the study group and 25% in the control group, p = 0.009). The study group also demonstrated a significant reduction in mortality and a 25% improvement in the Glasgow Outcome Scale (GOS) at 30 and 90 days, with no improvement in the control group (p = 0.001). Additionally, there was a marked reduction in PSH episodes and daily sedative bolus requirements in the gabapentin group.

Conclusion

This study provides compelling evidence that gabapentin may be critical in preventing PSH and enhancing neurological outcomes in TBI patients, potentially offering a novel therapeutic approach to improve survival and recovery.

Recommendation

According to the study, gabapentin may be an effective treatment for TBI patients. Gabapentin reduced secondary brain injury, improved functional outcomes (GOS and GCS), and decreased PSH episodes, suggesting a neuroprotective effect in TBI therapy.