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The most clinical scoring of traumatic brain injury patient is Glasgow Coma Scale (GCS) score. Lower GCS score higher IL-6 level and higher morbidity and mortality. Neuroinflammation is one mechanism of secondary brain injury. Selective cyclooxygenase (sCOX-2) inhibitors are drugs commonly used in treatment of postoperative pain but also possess an anti-inflammatory effect. The aim of this study is to determine the role of sCOX-2 inhibitors as inhibitors of inflammatory processes in patients with head injury measured by IL-6.
This is a double blind randomized controlled study involving patients with moderate head injuries who underwent surgery in Dr. Hasan Sadikin Hospital Bandung Indonesia since December 2013 until December 2015. After obtaining approval of research ethics committees from School of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, samples were divided randomly into 5 groups: control group, COX2-group I (given sCOX-2 inhibitor ones), COX2-group II (given sCOX-2 inhibitor twice), COX2-group III (given sCOX-2 inhibitor thrice), and COX2- group IV (given sCOX-2 inhibitor four times), each group containing 6 patients. All patients received standard therapy as recommended by Traumatic Brain Foundation in 2007 as well as monitoring of GCS, blood pressure, pulse rate, respiratory rate, oxygen saturation, temperature and blood sugar in pre and postoperative stages. The data was analyzed using statistical tests Paired Samples T-test and One Way Anova, p-value <0.05 as statistical significant.
Result shows that data pretest IL-6, data posttest and IL-6 changes of both groups is not significance (p>0.05). In treatment group (Cox-2 I, Cox-2 II, Cox-2 III dan Cox-2 IV) overall are decrease of IL-6=10%, which is p 0.083<0.10, if p=0.05 that is not significance (p>0.05).
The study is concluded that sCOX-2 inhibitor has a brain protective effect by lowering IL-6 level in patients with moderate head injury.