Abstract: AIM: To investigate the effect of remifentanil in the management of sedation and analgesia after severe traumatic brain injury and its influence on the incidence of inflammatory stress.  METHODS: From January 2017 to April 2020, 92 patients with severe head trauma surgery in our hospital were selected as the research objects, randomly divided into groups, each with 46 cases. Both groups received postoperative sedation and analgesia management, the control group received dexmedetomidine + 0.9%sodium chloride injection, and the observation group received dexmedetomidine combined with remifentanil. The effects of sedation and analgesia, vital signs, and inflammatory stimuli ［C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10)］ related indicators, serum cortisol, β-endorphin, and the incidence of adverse reactions in the two groups were observed and counted. RESULTS: The scores of sedation and analgesia in the observation group were lower than control group at 2 h, 4 h, and 12 h after administration (P<0.05). The heart rate, average arterial pressure, and respiratory rate of the observation group were lower than control group at 6 h after administration, and the average arterial pressure and respiratory rate at 12 h after administration were lower than those of the control group (P<0.05). At 6 h and 12 h after administration, the levels of CRP, TNF-α, IL-6, IL-10, and cortisol in the observation group were lower than control group, while the levels of β-endorphin were higher than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION: Remifentanil is used in the management of sedation and analgesia after severe traumatic brain injury, which can effectively improve the effect of sedation and analgesia, reduce inflammatory stimulation, regulate the levels of cortisol, and β-endorphin  It is worthy of clinical application. 

Key words: severe craniocerebral trauma, sedation and analgesia management, dexmedetomidine, remifentanil, inflammatory stress