Clinical experience with dexmedetomidine for implantation of deep brain stimulators in Parkinson's disease.
The pharmacologic profile of the alpha-2 agonist dexmedetomidine (Dex) suggests that it may be an ideal sedative drug for deep brain stimulator (DBS) implantation. We performed a retrospective chart review of anesthesia records of patients who underwent DBS implantation from 2001 to 2004. In 2003, a clinical protocol with Dex sedation for DBS implantation was initiated. Demographic data, use of antihypertensive medication, and duration of mapping were compared between patients who received Dex (11 patients/13 procedures) and patients who did not receive any sedation (controls: 8 patients/9 procedures). There were no differences in severity of illness between the two groups. Dex provided patient comfort and surgical satisfaction with mapping in all cases, and significantly reduced the use of antihypertensive medication (54% in the Dex group, versus 100% in controls, P = 0.048). In DBS implantation, sedation with Dex did not interfere with electrophysiologic mapping, and provided hemodynamic stability and patient comfort. Routine use of Dex in these procedures may be indicated.
Rozet
Irene
I
Department of Anesthesiology, University of Washington, Seattle, Washington, USA. i_rozet@hotmail.com
Muangman
Saipin
S
Vavilala
Monica S
MS
Lee
Lorri A
LA
Souter
Michael J
MJ
Domino
Karen J
KJ
Slimp
Jefferson C
JC
Goodkin
Robert
R
Lam
Arthur M
AM
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods*; D020927:Dexmedetomidine / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies
D020927:Dexmedetomidine