Egyptian Journal of Anaesthesia (Dec 2023)

The anti-inflammatory effects of atorvastatin upon the outcome of traumatic brain injury patients: A randomized-controlled double-blind clinical trial

  • Emad Zarief Kamel,
  • Nagwa M Ibrahem,
  • Hazem Abu Zeid Yousef,
  • Mohammed Gaber Farghly,
  • Shady Safwat Hassan,
  • Khaled Tolba Younes,
  • Yasser Ashraf Gamal,
  • Mina Maher Raouf,
  • Omar Makram Soliman

DOI
https://doi.org/10.1080/11101849.2023.2246232
Journal volume & issue
Vol. 39, no. 1
pp. 715 – 721

Abstract

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ABSTRACTBackground Traumatic brain injury (TBI) is a quite common health problem. A lot of delayed complications are related to inflammatory responses that occurred within the brain itself. Atorvastatin is related to lipid lowering drugs carrying some anti-inflammatory properties and upon this fact this study hypothesis was built.Methods Twenty adult patients with TBI, Glasgow coma scale (GCS) 9–11. Patients were equally and randomly allocated into two groups (group C as control group and group S received atorvastatin 40 mg once daily for 48 h). After 48 h, participants have undergone magnetic resonance imaging brain spectroscopy examination (MRS). The spectral peaks of N-Acetyl aspartate (NAA), Choline, and Creatinine (Cr) were assessed in brain tissue. The primary outcome was presented as ratios of NAA/Cr), Cho/Cr, and NAA/Cho. Other outcomes included GCS and ICU stay.Results There were insignificant variations between groups were found in the MRS results for metabolite alterations (NAA, Cr, and Cho). Contrasted with the control group, the statin group’s Cho/Cr ratio was significantly lower (P = 0.005), and NAA/Cho was significantly greater in the statin group than control group (P = 0.022). Statin group showed higher GCS the 1st day (P = 0.01), and lesser ICU stay (P = 0.04)Conclusion Atorvastatin can be used safely in mild-to-moderate TBI patients with a favourable outcome in the form of decreased Cho/Cr ratio and increased NAA/Cho ratio, higher GCS, and decreased ICU length of stay.

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