Pakistan Journal of Pharmaceutical Sciences

Abstract: Background: Severe brain injury patients often require effective analgesia and sedation to manage pain, agitation, and inflammatory responses, which can impact clinical outcomes. Objectives: This study aimed to analyze the effects of ketamine combined with remifentanil on analgesic sedation and inflammatory factors in patients with severe brain injury. Methods: Sixty patients were randomly divided into a remifentanil-only control group and a ketamine combined with remifentanil group. VAS, SAS, BCS, Ramsay scores, inflammatory factors (TNF-?, IL-2), and adverse reactions were compared. Results: Compared with pre-operative levels, both groups showed significant reductions in VAS, SAS scores, TNF-?, and IL-2 (P < 0.05). Compared with the control group, the combined group exhibited significantly lower VAS and SAS scores, higher Ramsay sedation and BCS scores, and lower TNF-? and IL-2 levels (P < 0.05). There was no statistically significant difference in adverse reactions between groups (P > 0.05). Conclusion: Ketamine combined with remifentanil provides better analgesic and sedative effects in severe brain injury patients, effectively reducing pain and agitation, improving comfort, and suppressing inflammatory responses, demonstrating good clinical application value.