Comparison of efficacy of different doses of dexmedetomidine for sedation in patients with Parkinson's disease undergoing deep brain stimulation surgery / 中华麻醉学杂志

ABSTRACT

Objective To compare the efficacy of different doses of dexmedetomidine for sedation in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) surgery.Methods Seventy-five patients of both sexes with PD,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 48-72 yr,with body mass index of 18-24 kg/m2,undergoing elective DBS surgery,were divided into 3 groups (n =25 each) using a random number table method:different doses of dexmedetomidine groups (D1-3 groups).Dexmedetomidine was intravenously infused in a loading dose of 0.5 μg/kg at 10 min before local infiltration anesthesia with 0.25 ％ ropivacaine 10-20 ml,followed by an infusion of 0.3,0.5 and 0.8 μg · kg-1 · h-1 in D1-3 groups,respectively.The infusion of dexmedetomidine was suspended during neurological test,the patients were awakened,and dexmedetomidine was infused at 0.3,0.5 and 0.8 μg · kg-1 · h-1 until the end of the surgery after the test.Bispectral index (BIS) value was recorded immediately before anesthesia (T0),immediately after administration prior to wake-up (T1) and during neurological test (T2).The wake-up time and adverse reactions such as requirement for rescue analgesics,pulse oxygen saturation (SpO2) ＜ 90％ and snoring were recorded.Results Compared with group D1,the requirement for rescue analgesics and BIS value at T1,2 were significantly decreased in D2 and D3 groups,and the wake-up time was significantly prolonged,and the incidence of SpO2 ＜ 90％ and snoring was increased in group D3 (P＜0.05 or 0.01).Compared with group D2,the requirement for rescue analgesics and BIS value at T1 were significantly decreased,the wake-up time was prolonged,and the incidence of SpO2 ＜90％ and snoring was increased in group D3 (P＜0.05 or 0.01).Conclusion Dexmedetomidine 0.5 μg · kg-1 · h-1 can produce good sedative efficacy and safety for DBS surgery in patients with PD.