Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study

Ritu Singh; Suruchi Ambasta; Prateek Singh Bais; Afzal Azim; Sanjeev Kumar; Bhawesh Upreti; Siddharth Singh; Prabhakar Mishra

doi:10.5005/jp-journals-10071-24634

Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study

Indian J Crit Care Med. 2024 Feb;28(2):120-125. doi: 10.5005/jp-journals-10071-24634.

Authors

Ritu Singh¹, Suruchi Ambasta², Prateek Singh Bais², Afzal Azim³, Sanjeev Kumar⁴, Bhawesh Upreti¹, Siddharth Singh¹, Prabhakar Mishra⁵

Affiliations

¹ Department of Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
² Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
³ Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
⁴ Department of Anaesthesiology and Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
⁵ Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Abstract

Background: Traumatic brain injury (TBI) is a major cause of mortality among young individuals, accounting for 65% of deaths in road traffic accidents. Paroxysmal sympathetic hyperactivity (PSH) is a common syndrome associated with TBI. This study represents the first prospective investigation aimed at assessing the impact of gabapentin on TBI patients, focusing on the prevention of secondary brain injury and brain edema while enhancing the Glasgow Coma Scale (GCS).

Materials and methods: The study was conducted from September 2019 to July 2021 after receiving ethical committee approval. It included adult ICU patients (≥18 years) with moderate and severe GCS. Patients below 18 years, death within 48 hours, non-consenting, pregnant females, and individuals allergic to gabapentin were excluded from the study. Patients were randomly allocated in two groups: study group received 300 mg of gabapentin orally twice daily and control group received multivitamin tablets twice daily. The treatment period spanned 2 weeks. Follow-up occurred in the ICU and continued for up to 3 months post-discharge, including telephonic conversations.

Results: About 60 patients were involved for analysis. Significant differences were found in GCS change from admission to discharge, Glasgow Outcome Scale (GOS) at 30 and 90 days, PSH episodes, and sedation bolus per day. Glasgow Coma Scale change was 53% in the study group compared with 25% in the control group (p = 0.009). Mortality was significantly lower in the study group. Glasgow Outcome Scale change between 30 and 90 days showed a 25% improvement in cases and no change in controls (p = 0.001).

Conclusion: This pioneering study underscores the potential of gabapentin in managing traumatic brain injuries.

How to cite this article: Singh R, Ambasta S, Bais PS, Azim A, Kumar S, Upreti B, et al. Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study. Indian J Crit Care Med 2024;28(2):120-125.

Keywords: Gabapentin; Paroxysmal sympathetic hyperactivity; Traumatic brain injury.