title: Dexmedetomidine for monitored anesthesia care in patients undergoing liberation procedure for multiple sclerosis: An observational study.
abstract: BACKGROUND
  It has been postulated that Multiple sclerosis (MS) stems from a narrowing in the veins that drain blood from the brain, known medically as chronic cerebrospinal venous insufficiency, or CCSVI. It has been proposed that balloon angioplasty should alleviate the symptoms of MS. This procedure is also known as The "Liberation Procedure". Accordingly, a clinical study was undertaken to determine the effects of dexmedetomidine in patients undergoing the liberation procedure.
  
  
  OBJECTIVE
  To assess the effectiveness of dexmedetomidine in providing adequate sedation and pain relief for patients undergoing the liberation procedure.
  
  
  METHODS
  A prospective, nonrandomized observational study of 60 consecutive adult patients undergoing the liberation procedure under monitored anesthesia care (MAC) who will receive dexmedetomidine as an anesthetic agent.
  
  
  METHODS
  A total of 60 adult patients were enrolled in the study. Dexmedetomidine was administered to all patients in a loading dose of 1 mcg/kg, which was followed by a maintenance dose of 0.2-0.5 mcg/kg/h. The evaluation of quality of sedation was based on Ramsay Sedation and the quality of analgesia was assessed using the visual analog scale. The following parameters were measured continuously: heart rate, mean arterial pressure and hemoglobin oxygen saturation. Patients were asked to answer the question, "How would you rate your experience with the sedation you have received during surgery?" using a seven-point Likert-like verbal rating scale.
  
  
  METHODS
  Repeated measurements were analyzed by repeated measures ANOVA for HR and BP.
  
  
  RESULTS
  Most of our patients were satisfied with their sedation. In most of the patients, MAP and HR dropped after the bolus dose of dexmedetomidine, and the drop was statistically significant.
  
  
  CONCLUSIONS
  Dexmedetomidine can be used as a sole sedative agent in patients undergoing the liberation procedure.
authors.affiliation: Institute of Critical Care and Anaesthesia Medanta, The Medicity, Gurgaon, Haryana, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Anand
authors.forename: Anshul
authors.initials: A
authors.lastname: Bhatia
authors.lastname: Rajkumar
authors.forename: Harsh
authors.initials: H
authors.lastname: Sapra
authors.forename: Vipul
authors.initials: V
authors.lastname: Gupta
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
keywords: Dexmedetomidine; monitored anesthesia care; multiple sclerosis liberation procedure