Dexmedetomidine and arousal affect subthalamic neurons
Identifieur interne : 002906 ( Main/Exploration ); précédent : 002905; suivant : 002907Dexmedetomidine 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.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Action Potentials (drug effects), Analgesics, Non-Narcotic (pharmacology), Arousal, Arousal (physiology), Deep Brain Stimulation (methods), Deep brain stimulation, Dexmedetomidine, Dexmedetomidine (pharmacology), Humans, Microelectrode, Microelectrodes, Nervous system diseases, Neuron, Neurons (drug effects), Parkinsonian Disorders (therapy), Retrospective Studies, Subthalamic Nucleus (cytology), Subthalamic Nucleus (drug effects), Subthalamic nucleus, deep brain stimulation, dexmedetomidine, microelectrode recording, subthalamic nucleus.
- MESH :
- chemical , pharmacology : Analgesics, Non-Narcotic, Dexmedetomidine.
- cytology : Subthalamic Nucleus.
- drug effects : Action Potentials, Neurons, Subthalamic Nucleus.
- methods : Deep Brain Stimulation.
- physiology : Arousal.
- therapy : Parkinsonian Disorders.
- Humans, Microelectrodes, Retrospective Studies.
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
Url:
DOI: 10.1002/mds.22080
Affiliations:
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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>Action Potentials (drug effects)</term><term>Analgesics, Non-Narcotic (pharmacology)</term><term>Arousal</term><term>Arousal (physiology)</term><term>Deep Brain Stimulation (methods)</term><term>Deep brain stimulation</term><term>Dexmedetomidine</term><term>Dexmedetomidine (pharmacology)</term><term>Humans</term><term>Microelectrode</term><term>Microelectrodes</term><term>Nervous system diseases</term><term>Neuron</term><term>Neurons (drug effects)</term><term>Parkinsonian Disorders (therapy)</term><term>Retrospective Studies</term><term>Subthalamic Nucleus (cytology)</term><term>Subthalamic Nucleus (drug effects)</term><term>Subthalamic nucleus</term><term>deep brain stimulation</term><term>dexmedetomidine</term><term>microelectrode recording</term><term>subthalamic nucleus</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Analgesics, Non-Narcotic</term><term>Dexmedetomidine</term></keywords><keywords scheme="MESH" qualifier="cytology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Action Potentials</term><term>Neurons</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Arousal</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Microelectrodes</term><term>Retrospective Studies</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dexmédétomidine</term><term>Eveil</term><term>Microélectrode</term><term>Neurone</term><term>Noyau sousthalamique</term><term>Pathologie du système nerveux</term><term>Stimulation cérébrale profonde</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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