Dexmedetomidine and Arousal Affect Subthalamic Neurons
Identifieur interne : 001293 ( PascalFrancis/Checkpoint ); précédent : 001292; suivant : 001294Dexmedetomidine 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.
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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.
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Durieux</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Anesthesiology, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Huss, Diane" sort="Huss, Diane" uniqKey="Huss D" first="Diane" last="Huss">Diane Huss</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Physical Therapy, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Frysinger, Robert C" sort="Frysinger, Robert C" uniqKey="Frysinger R" first="Robert C." last="Frysinger">Robert C. 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Durieux</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Anesthesiology, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Huss, Diane" sort="Huss, Diane" uniqKey="Huss D" first="Diane" last="Huss">Diane Huss</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Physical Therapy, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Frysinger, Robert C" sort="Frysinger, Robert C" uniqKey="Frysinger R" first="Robert C." last="Frysinger">Robert C. Frysinger</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurosurgery, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Virginie</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arousal</term><term>Deep brain stimulation</term><term>Dexmedetomidine</term><term>Microelectrode</term><term>Nervous system diseases</term><term>Neuron</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie du système nerveux</term><term>Dexmédétomidine</term><term>Eveil</term><term>Neurone</term><term>Noyau sousthalamique</term><term>Microélectrode</term><term>Stimulation cérébrale profonde</term></keywords></textClass></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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Dexmedetomidine and Arousal Affect Subthalamic Neurons</s1></fA08><fA11 i1="01" i2="1"><s1>ELIAS (William Jeffrey)</s1></fA11><fA11 i1="02" i2="1"><s1>DURIEUX (Marcel E.)</s1></fA11><fA11 i1="03" i2="1"><s1>HUSS (Diane)</s1></fA11><fA11 i1="04" i2="1"><s1>FRYSINGER (Robert C.)</s1></fA11><fA14 i1="01"><s1>Department of Neurosurgery, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Anesthesiology, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Physical Therapy, University of Virginia</s1><s2>Charlottesville, Virginia</s2><s3>USA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>1317-1320</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000196264160230</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>13 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0396207</s0></fA47><fA60><s1>P</s1><s3>CC</s3></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>: 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. 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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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