COMPARISON OF THE EFFECTS OF HALOPERIDOL VERSUS DEXMEDETOMIDINE ON AGITATION AMONG NON- INTUBATED PATIENTS WITH TRAUMATIC BRAIN INJURY, AN OBSERVATIONAL STUDY

Abstract

Background: Traumatic brain injury (TBI) is the result of an external force being delivered to the head. This can result in altered brain function, including decreased consciousness and post-traumatic agitation, as well as long-lasting changes in cognition and behavior. Agitation is a common side effect of traumatic brain injury for patients in a hospital environment. A significant portion of the heterogeneity is explained by differences in the diagnostic criteria and the over- or under-recognition of these behaviors. Aim: To compare the effects of haloperidol versus dexmedetomidine for the treatment of agitation in non-intubated patients with Traumatic brain injury in the intensive care unit. Methodology: An observational, prospective study design was conducted at Specialized Arab Hospital (SAH) – Nablus. The study population was TBI patients who suffered from agitation in SAH. Convenience sampling was used; the sample size is 60 patients. The data collection tool was self-developed according to the literature review. Result: The groups' baseline clinical and demographic features were similar (p >.05). Over the course of seven days, there was no discernible difference in cute Physiology and Chronic Health Evaluation II (APACHE II), Glasco coma scale (GCS), or most Richmond Agitation-Sedation Scale (RASS) scores, and both groups progressively improved. Two RASS time points showed significant differences between deeper sedation with Dexmedetomidine on Day 2 and deeper sedation with Haloperidol on Day 5. While dexmedetomidine was associated with higher rates of bradycardia (26.7%), haloperidol showed more extrapyramidal symptoms (23.3%). These variations in the profiles of complications were statistically significant (p =.007). The duration of mechanical ventilation, length of hospital stay, intensive care unit stay, and discharge outcomes did not significantly differ (p >.05). Conclusion: Dexmedetomidine and haloperidol have comparable clinical outcomes and general agitation control for non-intubated TBI patients. However, the profiles of their side effects differ: dexmedetomidine causes more bradycardia, whereas haloperidol causes more extrapyramidal symptoms. These findings highlight how important it is to select sedatives tailored to each patient's risk factors and monitoring needs.