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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1492604
This article is part of the Research Topic Current Advances and Challenges in Neurocritical Care after Reperfusion Therapy: From Bench Work to Practical Aspects View all articles

Influences of Different Sedatives on Gastric Antrum Contraction in Patients with Acute Brain Injury

Provisionally accepted
Meihua Mei Meihua Mei *Mingli Yao Mingli Yao Jingchao Li Jingchao Li Chunfang Qiu Chunfang Qiu Yufang Wang Yufang Wang Yan Li Yan Li Lei Shi Lei Shi Lingyan Wang Lingyan Wang Bin Ouyang Bin Ouyang *
  • The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Patients with acute brain injury (ABI) often exhibit gastrointestinal motility disorder and the administration of sedatives may exacerbate the gastrointestinal dysfunction. This study aims to evaluate the influences of different sedatives on gastric antrum contraction in patients with acute brain injury (ABI).Methods: A prospective observational study was performed in 37 adult ICU patients with ABI, and 18 adult healthy volunteers were recruited as normal controls. Gastric motility, including frequency (ACF), amplitude (ACA), and motility index (MI), was measured with ultrasound before and after using sedatives, either propofol (Group A), midazolam (Group B), or dexmedetomidine (Group C). The influences of different sedatives on gastric motility were analyzed.Results: All patients with acute brain injury (n=37) exhibited decreased ACF and MI compared with those in healthy control (n=18) (ACF: 2.41 ± 0.89 times/2mins in ABI vs.4.5 ± 0.39 times/2mins in control, MI: 1.25 ± 0.57 in ABI vs. 3.59 ± 0.24 in control, p=0.001). All sedatives, either propofol, midazolam, or dexmedetomidine, had inhibited effects on gastric motilities (In Group A (n=13), 1.14(0.59,1.44) before vs. 0.84(0.09,0.83) after, p=0.002; In group B (n=12), 1.48(0.73,1.62) before vs 0.31(0.04,0.58) after, p=0.007; In Group C (n=12), 2.74(1.70,3.01) before vs.1.39(0.70,2.28). However, dexmedetomidine showed significantly less inhibition either on ACA or MI compared with propofol and midazolam (ACA 20.67 ± 33.59% in dexmedetomidine, 51.50 ± 32.83% in propofol, 60.43 ± 22.40% in midazolam, p=0.002; MI 36.00 ± 34.77% in dexmedetomidine, 60.69 ± 27.49% in propofol, 68.81 ± 20.84% in midazolam, p=0.012).Patients with ABI exhibited decreased gastric motility. All sedatives, either propofol, midazolam, or dexmedetomidine, had inhibited effects on gastric motilities.Dexmedetomidine has less inhibitory effects on ACA and MI compared with propofol and midazolam.

    Keywords: Acute brain injury, sedatives, Gastric antrum, Ultrasound, Gastric motility, Propofol, Midazolam, Dexmedetomidine acute brain injury, sedation

    Received: 07 Sep 2024; Accepted: 05 Dec 2024.

    Copyright: © 2024 Mei, Yao, Li, Qiu, Wang, Li, Shi, Wang and Ouyang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Meihua Mei, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
    Bin Ouyang, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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