Abstract
BACKGROUND: To compare the effects of fentanyl combined with midazolam versus thiopental on serum levels of S100B in critically ill patients with brain injury. METHODS: Eighty-five patients who underwent neurosurgical interventions and required mechanical ventilation were included in the study. The Sequential Organ Failure Assessment (SOFA) score, duration of ventilation, length of intensive care unit (ICU) stay, and serum levels of S100B were measured and compared at baseline, day 3, and day 5 of the study. RESULTS: Seventy out of the 85 selected patients were randomized. There were no significant differences in the levels of S100B at admission (P = 0.7) and on day 3. However, on day 5, S100B levels were significantly lower in the thiopental group compared to the fentanyl plus midazolam group (P = 0.03). Although the duration of ventilation was shorter in the thiopental group, the difference was not statistically significant (P = 0.06). Additionally, the length of ICU stay was shorter for patients who received thiopental (214 hours vs. 209 hours, P = 0.4). CONCLUSIONS: Our study demonstrated that both thiopental and fentanyl combined with midazolam could reduce S100B levels in patients with traumatic brain injuries. Furthermore, patients receiving thiopental experienced a shorter ICU stay and duration of ventilation.