Dexmedetomidine and arousal affect subthalamic neurons

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...

Full description

Saved in:
Bibliographic Details
Published in:Movement disorders 2008-07, Vol.23 (9), p.1317-1320
Main Authors: Elias, William Jeffrey, Durieux, Marcel E., Huss, Diane, Frysinger, Robert C.
Format: Article
Language:English
Subjects:
Action Potentials - drug effects
Analgesics, Non-Narcotic - pharmacology
Arousal - physiology
Biological and medical sciences
deep brain stimulation
Deep Brain Stimulation - methods
dexmedetomidine
Dexmedetomidine - pharmacology
Fundamental and applied biological sciences. Psychology
Humans
Isolated neuron and nerve. Neuroglia
Medical sciences
microelectrode recording
Microelectrodes
Neurology
Neurons - drug effects
Parkinsonian Disorders - therapy
Retrospective Studies
subthalamic nucleus
Subthalamic Nucleus - cytology
Subthalamic Nucleus - drug effects
Vertebrates: nervous system and sense organs
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.22080