Rosati Dennis L
Department of Emergency Medicine, Traumatology, and Rehabilitation, Hartford Hospital, Hartford, Connecticut, USA.
Am J Phys Med Rehabil. 2002 Feb;81(2):90-3. doi: 10.1097/00002060-200202000-00003.
To evaluate clinical outcomes observed in the treatment of posttraumatic brain injury agitation with multiple medications.
Longitudinal evaluation of effect of treatment intervention on patients admitted to a level 1 trauma center with traumatic brain injury. Eleven adult patients referred for physiatry consultation to manage posttraumatic brain injury agitation were treated with a combination of medications and other agents (antipsychotics and sedatives) were discontinued. The Rancho Los Amigos scale was rated on initial consultation and follow-up, ranging from 1 to 3 wk.
All 11 patients demonstrated an average improvement of three Rancho Los Amigos levels within an average treatment duration of 10 days. Simultaneously, 9 of 11 patients were discontinued from treatment and prescribed antipsychotic and sedative agents.
The findings suggest that administration of multiple neuropharmacologic agents used early in the treatment of posttraumatic brain injury agitation may be an effective therapeutic intervention in which behavioral and, possibly, cognitive benefits occur. These results were noted as patients were discontinued from other agents more commonly employed in the acute care setting for the treatment of posttraumatic brain injury agitation. Further research is needed to determine the most effective medication combinations and the best time to initiate treatment.
评估多种药物治疗创伤性脑损伤后激越的临床疗效。
对入住一级创伤中心的创伤性脑损伤患者进行治疗干预效果的纵向评估。11名因创伤性脑损伤后激越而转诊至物理医学与康复科咨询的成年患者接受了联合用药治疗，停用了其他药物（抗精神病药和镇静剂）。在初次咨询和随访时采用Rancho Los Amigos量表进行评分，随访时间为1至3周。
11名患者在平均10天的治疗期内平均Rancho Los Amigos量表评分提高了三个等级。同时，11名患者中有9名停止治疗并停用了抗精神病药和镇静剂。
研究结果表明，在创伤性脑损伤后激越治疗早期使用多种神经药物可能是一种有效的治疗干预措施，可带来行为改善，可能还有认知改善。这些结果是在患者停用急性护理环境中更常用于治疗创伤性脑损伤后激越的其他药物时观察到的。需要进一步研究以确定最有效的药物组合和开始治疗的最佳时机。
