title: Dexmedetomidine may impair cognitive testing during endovascular embolization of cerebral arteriovenous malformations: a retrospective case report series.
abstract: After the reported successful use of dexmedetomidine to sedate patients in the intensive care unit without respiratory depression, we began to use dexmedetomidine for interventional neuroradiologic procedures. We report on five patients who had dexmedetomidine administered for sedation during embolization of cerebral arteriovenous malformations. All patients were comfortably sedated and breathing spontaneously. However, although patients were awake and following simple commands 10 minutes after the discontinuation of the infusion of dexmedetomidine, they were nevertheless unable to undergo cognitive testing. They were still unable to undergo cognitive testing 45 minutes after the infusion was stopped. In contrast, 10 minutes after the discontinuation of the infusion of propofol, all patients were awake, alert, cooperative, and able to undergo cognitive testing without difficulty. In conclusion, on examination of five non-randomly selected case records, we found that dexmedetomidine significantly prevented neurologic and cognitive testing.
authors.affiliation: Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bustillo
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Lazar
authors.forename: A Donald
authors.initials: AD
authors.lastname: Finck
authors.forename: Brian
authors.initials: B
authors.lastname: Fitzsimmons
authors.forename: Mitchell F
authors.initials: MF
authors.lastname: Berman
authors.forename: John
authors.initials: J
authors.lastname: Pile-Spellman
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Heyer
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000328:Adult; D002533:Cerebral Angiography; D003071:Cognition / Q000187:drug effects*; D020927:Dexmedetomidine / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D002538:Intracranial Arteriovenous Malformations / Q000523:psychology* / Q000628:therapy*; D007431:Intraoperative Complications / Q000523:psychology*; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies
chemical_list: D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam; D005283:Fentanyl