CC BY-NC-ND 4.0 · J Neurosci Rural Pract 2014; 05(S 01): S017-S021
DOI: 10.4103/0976-3147.145195
Original Article
Journal of Neurosciences in Rural Practice

Hemodynamic effects of dexmedetomidine during intra-operative electrocorticography for epilepsy surgery

G. Chaitanya
Department of Clinical Neuroscience, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
A. Arivazhagan
1  Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
Sanjib Sinha
2  Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
K. R. Madhusudan Reddy
3  Department of Neuro Anesthesiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
K. Thennarasu
4  Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
,
R. D. Bharath
5  Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
M. Bhaskara Rao
1  Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
B. A. Chandramouli
1  Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
,
P. Satishchandra
2  Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
› Author Affiliations
Further Information

Address for correspondence:

Dr. A Arivazhagan
Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS)
Bangalore, Karnataka
India   

Publication History

Publication Date:
26 September 2019 (online)

 

ABSTRACT

Background: Dexmedetomidine, a predominant alpha-2-adrenergic agonist has been used in anesthetic practice to provide good sedation. The drug is being recently used in neuroanesthesia during awake surgery for brain tumors and in functional neurosurgery. Materials and Methods: This prospective study analyzed the hemodynamic effects of dexmedetomidine infusion during electrocorticography in patients undergoing surgery for mesial temporal sclerosis. Dexmedetomidine infusion was administered during intra-operative electrocorticography recording, 15 minutes after the end tidal MAC of N 2 O and isoflurane were decreased to zero. Anesthesia was maintained with O 2 :air mixture = 50:50, vecuronium and fentanyl. Heart rate (HR), mean arterial pressure (MAP) and end tidal carbon dioxide (ETCO 2) were recorded across at induction, 2 min prior to dexmedetomidine (PreDEX), 5 min during dexmedetomidine infusion (DEX; 1 μg/kg), 5 min after stopping dexmedetomidine and 10 minutes after stopping dexmedetomidine. Results: Forty patients with mesial temporal sclerosis (M: F = 27:13, mean age = 28.15 ± 10.9 years; duration of epilepsy = 12.0 ± 7.9 years) underwent anterior temporal lobe resection with amygdalohippocampectomy for drug-resistant epilepsy. Infusion of dexmedetomidine caused a transient fall in HR in 87.5% of patients and an increase in MAP in 62.5% of patients, which showed a tendency to revert back towards PreDEX values within 10 min after stopping the infusion. Sixty-five percent of the patients showed ≤25% reduction and 10% of them showed >25% reduction in HR. 47.5% of the patients showed ≤25% increase and 15% of them showed >25% increase in MAP. These changes were over a narrow range and within physiological limits. Conclusion: The infusion of dexmedetomidine for a short period causes reduction of HR and increase in MAP in patients, however the variations are within acceptable range.


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Conflicts of interest

None declared.


Address for correspondence:

Dr. A Arivazhagan
Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS)
Bangalore, Karnataka
India