title: Sedation with α2 Agonist Dexmedetomidine During Unilateral Subthalamic Nucleus Deep Brain Stimulation: A Preliminary Report.
abstract: OBJECTIVE
  The α2 agonist dexmedetomidine (DEX) is an anesthetic agent that can provide sedation and analgesia without respiratory depression or changes in neuronal activity during microrecordings. The aim of our study was to confirm the efficacy and safety of anesthesia with DEX for unilateral deep brain stimulation of the subthalamic nucleus (STN) in patients with Parkinson disease.
  
  
  METHODS
  In 2013 and 2014, a series of 11 consecutive patients received continuous low-dose DEX infusion during unilateral deep brain stimulation of the STN. Intraoperative microrecordings, stimulation results, and patient reaction times in executing verbal and motor tasks were retrospectively analyzed. Functional outcomes were evaluated by comparing preoperative and 1-year postoperative Unified Parkinson's Disease Rating Scale Part III scores.
  
  
  RESULTS
  Typical activity of the STN was recorded in all patients, and the delay in the execution of both motor and verbal tasks was ≤2 seconds. No hemorrhagic complications occurred, and no postoperative side effects were observed. The mean percentage of Unified Parkinson's Disease Rating Scale Part III improvement at last follow-up was 39.01% (range, 23.70%-55.60%). The mean percentage of levodopa equivalent dose reduction was 45.86% (range, 21.50%-65.70%).
  
  
  CONCLUSIONS
  The results of our study confirm that the use of DEX in managing patients with Parkinson disease during unilateral deep brain stimulation of the STN is safe and effective and can be considered a promising option for sedation during this type of procedure.
authors.affiliation: Neurosurgical Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Morace
authors.affiliation: Division of Neurosurgery, Federico II University of Naples, Naples, Italy. Electronic address: michelangelo.dea@gmail.com.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: De Angelis
authors.affiliation: Anaesthesiological Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Aglialoro
authors.affiliation: Anaesthesiological Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Maucione
authors.affiliation: Division of Neurosurgery, Federico II University of Naples, Naples, Italy.
authors.forename: LuigiMaria
authors.initials: L
authors.lastname: Cavallo
authors.affiliation: Division of Neurosurgery, Federico II University of Naples, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Solari
authors.affiliation: Neurological Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Modugno
authors.affiliation: Neurological Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Santilli
authors.affiliation: Neurosurgical Department, IRCCS Neuromed, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.affiliation: Anaesthesiological Department, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Aloj
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000379:methods*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D064795:Intraoperative Neurophysiological Monitoring; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D011930:Reaction Time; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013060:Speech / Q000187:drug effects / Q000502:physiology; D020531:Subthalamic Nucleus / Q000187:drug effects* / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000978:Antiparkinson Agents; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine
keywords: Deep brain stimulation; Dexmedetomidine; Parkinson; Subthalamic nucleus; α(2) agonist