Dexmedetomidine and arousal affect subthalamic neurons.
Identifieur interne : 002240 ( PubMed/Curation ); précédent : 002239; suivant : 002241Dexmedetomidine and arousal affect subthalamic neurons.
Auteurs : William Jeffrey Elias [États-Unis] ; Marcel E. Durieux ; Diane Huss ; Robert C. FrysingerSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- Action Potentials (drug effects), Analgesics, Non-Narcotic (pharmacology), Arousal (physiology), Deep Brain Stimulation (methods), Dexmedetomidine (pharmacology), Humans, Microelectrodes, Neurons (drug effects), Parkinsonian Disorders (therapy), Retrospective Studies, Subthalamic Nucleus (cytology), Subthalamic Nucleus (drug effects).
- 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.
DOI: 10.1002/mds.22080
PubMed: 18442130
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Durieux</name></author><author><name sortKey="Huss, Diane" sort="Huss, Diane" uniqKey="Huss D" first="Diane" last="Huss">Diane Huss</name></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></author><author><name sortKey="Huss, Diane" sort="Huss, Diane" uniqKey="Huss D" first="Diane" last="Huss">Diane Huss</name></author><author><name sortKey="Frysinger, Robert C" sort="Frysinger, Robert C" uniqKey="Frysinger R" first="Robert C" last="Frysinger">Robert C. Frysinger</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Action Potentials (drug effects)</term><term>Analgesics, Non-Narcotic (pharmacology)</term><term>Arousal (physiology)</term><term>Deep Brain Stimulation (methods)</term><term>Dexmedetomidine (pharmacology)</term><term>Humans</term><term>Microelectrodes</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></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></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><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">18442130</PMID><DateCreated><Year>2008</Year><Month>08</Month><Day>05</Day></DateCreated><DateCompleted><Year>2009</Year><Month>01</Month><Day>12</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>9</Issue><PubDate><Year>2008</Year><Month>Jul</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Dexmedetomidine and arousal affect subthalamic neurons.</ArticleTitle><Pagination><MedlinePgn>1317-20</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22080</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>(c) 2008 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Elias</LastName><ForeName>William Jeffrey</ForeName><Initials>WJ</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, University of Virginia, Charlottesville, Virginia 22908, USA. wje4r@virginia.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Durieux</LastName><ForeName>Marcel E</ForeName><Initials>ME</Initials></Author><Author ValidYN="Y"><LastName>Huss</LastName><ForeName>Diane</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Frysinger</LastName><ForeName>Robert C</ForeName><Initials>RC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018712">Analgesics, Non-Narcotic</NameOfSubstance></Chemical><Chemical><RegistryNumber>67VB76HONO</RegistryNumber><NameOfSubstance UI="D020927">Dexmedetomidine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="ErratumIn"><RefSource>Mov Disord. 2008 Aug 15;23(11):1638</RefSource></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000200">Action Potentials</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000187">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018712">Analgesics, Non-Narcotic</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000494">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001143">Arousal</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000502">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D046690">Deep Brain Stimulation</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020927">Dexmedetomidine</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000494">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008839">Microelectrodes</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009474">Neurons</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000187">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020734">Parkinsonian Disorders</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000628">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012189">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020531">Subthalamic Nucleus</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000166">cytology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000187">drug effects</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2008</Year><Month>4</Month><Day>30</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2009</Year><Month>1</Month><Day>13</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2008</Year><Month>4</Month><Day>30</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.22080</ArticleId><ArticleId IdType="pubmed">18442130</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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