Advantages of dexmedetomidine in traumatic brain injury - a review

Patients with traumatic brain injury (TBI) require mechanical ventilation for airway protection, to reduce work of breathing, to reduce cerebral metabolic rate and to optimize intracerebral hemodynamics. Drugs like narcotics, benzodiazepines, propofol and alpha-2 agonists with or without non-depolarizing muscle relaxants are used to facilitate mechanical ventilation. We reviewed literature on search engines PubMed and Medline to determine the efficacy and feasibility of dexmedetomidine as the sole sedative agent in patients with TBI in terms of maintenance of hemodynamics, ease of neurological assessment with ongoing sedation and long term neurological outcome.