Abstract: Objective　To explore the effect of dexmedetomidine-esmolol combination therapy on the lactic acid contents, the levels of S100B, intracranial pressure (ICP) and outcome in patients with severe traumatic brain injury undergoing decompression craniectomy. Methods　Sixty patients with severe craniocerebral trauma who underwent unilateral craniocerebral decompression from January 2015 to December 2018 were selected as the observation objects. According to the application of postoperative sedative drugs, the patients were divided into two groups: the co-treatment group of esmolol combined with dexmedetomidine (the co-treatment group, n=30) and the control group of dexmedetomidine alone (the control group, n=30). Cerebrospinal fluid (CSF) was collected before treatment and on 1, 3 and 7 d after treatment. The lactic acid contents and the levels of S100B of the CSF were detected. Glasgow coma scale (GCS) score and National Institute of Health stroke scale (NIHSS) score were compared 14 d after treatment between the two groups. Glasgow outcome scale (GOS) score were used to evaluate long-term outcome on 6 months after treatment. Results　After treatment, CSF lactic acid content and S100B level decreased significantly at 1, 3 and 7 d after treatment in co-treatment group than those of the control group (P＜0.05). The GCS score and NIHSS score were significantly higher at 14 d after treatment in the co-treatment group than those in the control group (P＜0.01). There was no significant difference in the GOS score within 6-month follow up between the two groups of patients (P＞0.05). Conclusion　Dexmedetomidine-esmolol combination therapy can reduce the levels of CSF lactic acid and S100B in patients with severe traumatic brain injury undergoing decompression craniectomy and improve the short-term outcome, but it has no significant effect on the long-term prognosis.

Key words: craniocerebral trauma, cerebrospinal fluid, lactic acid, S100 calcium binding protein beta subunit, intracranial pressure, prognosis, esmolol, dexmedetomidine, S100B