Dexmedetomidine and arousal affect subthalamic neurons
Identifieur interne : 001462 ( Istex/Checkpoint ); précédent : 001461; suivant : 001463Dexmedetomidine and arousal affect subthalamic neurons
Auteurs : William Jeffrey Elias [États-Unis] ; Marcel E. Durieux [États-Unis] ; Diane Huss [États-Unis] ; Robert C. Frysinger [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-07-15.
English descriptors
Abstract
Stereotactic neurosurgeons hesitate to employ sedation in cases requiring microelectrode recording (MER). We report our experience with dexmedetomidine during MER of subthalamic nucleus (STN). Eleven Parkinsonian patients received dexmedetomidine during deep brain stimulation surgery. Seven received continuous IV infusions during MER in the STN. The bispectral index (BIS) was used to estimate the level of consciousness. The quality of MER was evaluated as a function of BIS, clinical arousal, and dexmedetomidine dose. MER during wakefulness (BIS > 80; 0.1 to 0.4 mcg/kg/hr dexmedetomidine) was similar to the unmedicated state. Subthalamic MER was reduced when the patient was asleep or unarousable (BIS < 80). Anxiolysis persisted for hours. Arousal affects STN neurons. Dexmedetomidine “cooperative sedation,” from which the patient is easily aroused, provides interpretable STN MER and prolonged anxiolysis. We suggest dexmedetomidine infusions without a loading dose, a relatively low infusion rate, and discontinuation after completion of the bur holes. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22080
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-07-15">2008-07-15</date><biblScope unit="vol">23</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1317">1317</biblScope><biblScope unit="page" to="1320">1320</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">643E4E2D25C94DFA21BBBD5CF2CBBC8C381CA166</idno><idno type="DOI">10.1002/mds.22080</idno><idno type="ArticleID">MDS22080</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>deep brain stimulation</term><term>dexmedetomidine</term><term>microelectrode recording</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Stereotactic neurosurgeons hesitate to employ sedation in cases requiring microelectrode recording (MER). We report our experience with dexmedetomidine during MER of subthalamic nucleus (STN). Eleven Parkinsonian patients received dexmedetomidine during deep brain stimulation surgery. Seven received continuous IV infusions during MER in the STN. The bispectral index (BIS) was used to estimate the level of consciousness. The quality of MER was evaluated as a function of BIS, clinical arousal, and dexmedetomidine dose. MER during wakefulness (BIS > 80; 0.1 to 0.4 mcg/kg/hr dexmedetomidine) was similar to the unmedicated state. Subthalamic MER was reduced when the patient was asleep or unarousable (BIS < 80). Anxiolysis persisted for hours. Arousal affects STN neurons. Dexmedetomidine “cooperative sedation,” from which the patient is easily aroused, provides interpretable STN MER and prolonged anxiolysis. We suggest dexmedetomidine infusions without a loading dose, a relatively low infusion rate, and discontinuation after completion of the bur holes. © 2008 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Virginie</li></region></list><tree><country name="États-Unis"><region name="Virginie"><name sortKey="Elias, William Jeffrey" sort="Elias, William Jeffrey" uniqKey="Elias W" first="William Jeffrey" last="Elias">William Jeffrey Elias</name></region><name sortKey="Durieux, Marcel E" sort="Durieux, Marcel E" uniqKey="Durieux M" first="Marcel E." last="Durieux">Marcel E. Durieux</name><name sortKey="Frysinger, Robert C" sort="Frysinger, Robert C" uniqKey="Frysinger R" first="Robert C." last="Frysinger">Robert C. Frysinger</name><name sortKey="Huss, Diane" sort="Huss, Diane" uniqKey="Huss D" first="Diane" last="Huss">Diane Huss</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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