The effect of methylphenidate on the level of consciousness and weaning from the ventilator in patients with brain injury in the intensive care unit | [Anaesthesia, Pain and Intensive Care • 2021]

Author(s):

1. Alireza Kamali: Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran.

2. Behnam Mahmodiyeh: Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran.

3. Seyed Mohammad Jamalian: Department of Forensic Medicine and Poisoning, Arak University of Medical Sciences, Arak, Iran

4. Anahita Kishani: Research Committee, Arak University of Medical Sciences, Arak, Iran

5. Mohsen Dalvandi: Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran

Abstract:

Introduction: Brain injury is the one of the leading cause of death and disability in the most active sections of society, especially in people under 45 y. The prevalence and severity of traumatic brain injury is rising in the Iranian population. The clinical effects of methylphenidate in improving treatment outcomes and cognitive function in this set of patients have been demonstrated in some studies. We conducted this clinical trial to assess the efficacy of methylphenidate in improving the level of consciousness and weaning from the ventilator in patients with brain injury in the intensive care unit. Methodology: This clinical trial study was performed on 90 intubated patients admitted to the intensive care unit of Valiasr Hospital in Arak, Iran. The patients were randomly divided into two groups. Patients in the intervention group (Group M) received methylphenidate 0.3 mg/kg twice daily, in addition to the routine drugs that the control group (Group C) received. All patients were compared for ventilator isolation, Glasgow Comma Scale (GCS) and APACHE II. The results were compared and analyzed in the two groups using SPSS software version 22. Results: The mean age of the patients in methylphenidate and control groups was 34.20 ± 7.87 y and 34.53 ± 8.31 y, respectively. There was no significant difference between the two groups in terms of age and gender (p > 0.05). The mean APACHE II score on the first and third day in Group M was 15.98 ± 1.70 and 13.73 ± 1.72, while in the Group C it was 16.02 ± 1.75 and 13.87 ± 1.84, respectively (p > 0.554). The GCS in the Group M was significantly and rapidly normalized (p < 0.0001). The mean duration of intubation in methylphenidate and Group Cs was 7.18 ± 0.83 and 9.8 ± 1.04 days, respectively. This time was significantly lower in the Group M (p < 0.0001). Conclusion: The use of methylphenidate in patients with traumatic brain injury on mechanical ventilation in the intensive care unit is associated with a reduced duration of intubation and early return of the level of consciousness to normal.

Page(s): 643-646

DOI: 10.35975/apic.v25i5.1633

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 25, Issue: 5, Year: 2021

Keywords:

Intensive care unit , Brain Injury , Methylphenidate , Glasgow Comma Scale , APACHE II score

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