title: Factors Associated with Tremor Changes during Sedation with Dexmedetomidine in Parkinson's Disease Surgery.
abstract: BACKGROUND
  Dexmedetomidine is an α2-agonist recently proposed as a potentially ideal drug for sedation during the surgical treatment of Parkinson's disease (PD). This report documents the incidence of changes in motor symptoms (especially tremor) in PD patients sedated with dexmedetomidine for deep brain stimulation or ablation procedures.
  
  
  METHODS
  We reviewed a retrospective cohort of 22 patients who underwent surgery for PD with dexmedetomidine sedation at a single institution from 2010 to 2014. A logistic regression analysis was performed to analyze possible confounding factors.
  
  
  RESULTS
  14 cases of tremor reduction or suppression were recorded (cumulative incidence: 63.6%; 95% CI: 40.7-82.8). No association could be identified between loading dose, β-blocker use and preoperative total Unified Parkinson's Disease Rating Scale III, with tremor changes. The maintenance dose of dexmedetomidine was higher in patients who did not experience changes [median and range for patients with and without tremor alteration 0.75 (0.2-1.0) and 1.0 µg × kg(-1) × h(-1) (0.7-1.4), respectively; p = 0.021].
  
  
  CONCLUSIONS
  Dexmedetomidine provides adequate sedation during surgery for PD, but it might affect motor signs making intraoperative testing difficult or even impossible. Dosage appears not to be the determining factor in motor changes, whose cause remains unclear.
authors.affiliation: Department of Anesthesiology and Critical Care, University Hospital Navarra, Pamplona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Honorato-Cia
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez-Simón
authors.forename: Manuel
authors.initials: M
authors.lastname: Alegre
authors.forename: Jorge
authors.initials: J
authors.lastname: Guridi
authors.forename: Elena
authors.initials: E
authors.lastname: Cacho-Asenjo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Panadero
authors.forename: Jorge M
authors.initials: JM
authors.lastname: Núñez-Córdoba
mesh_terms: D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014202:Tremor / Q000601:surgery*
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine