Brain tissue oxygenation during dexmedetomidine administration in surgical patients with neurovascular injuries

Journal of Neurosurgical Anesthesiology
John Cornell Drummond, Mary K Sturaitis

Abstract

Investigations in dogs have shown substantial dexmedetomidine (Dex)-induced reductions in cerebral blood flow (CBF) unaccompanied by reductions in cerebral metabolic rate (CMR). If this effect were to occur in humans in areas of injured brain in which CBF is already low, oxygen delivery might be critically impaired. The institutional use of brain PO2 monitoring during neurovascular surgery and the use of Dex as a component of the anesthetic allowed insight into this issue. Data from 5 neurovascular surgery patients, 2 for excision of arteriovenous malformations (AVMs), and 3 for intracranial aneurysm clipping were reviewed retrospectively. All had acute, lesion-related neurologic deficits. During general anesthesia with sufentanil and sevoflurane, with or without N2O, a parenchymal brain tissue PO2 (PbrO2) electrode was placed directly in the territory at risk from the pending neurosurgical intervention. After a stable PbrO2 value was achieved, Dex was administered by bolus (1 μg/kg over 10 min) and infusion (0.5 to 0.7 μg/kg/min). Mean arterial pressure (MAP), heart rate (HR), and PbrO2 were observed continuously for at least 25 minutes. Baseline PbrO2 values were relatively low (≤16 mm Hg) in 4 of the 5 patients, a pattern co...Continue Reading

References

Mar 1, 1993·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·M H ZornowS L Shafer
Aug 1, 1993·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·F BariG Benedek
Mar 22, 2002·Journal of Neurosurgical Anesthesiology·Teresa TijeroAlberto Puig
Mar 26, 2003·Journal of Neurosurgery·Andreas JödickeDieter-Karsten Böker
Sep 23, 2008·Anesthesia and Analgesia·Alex BekkerAbishabeck Pitti
Apr 28, 2009·Journal of Neurosurgery·Ross P MartiniMiriam M Treggiari
Aug 18, 2009·Journal of Anesthesia·Takaaki Nakano, Hirotsugu Okamoto

❮ Previous
Next ❯

Citations

Jun 14, 2013·Journal of Neurointerventional Surgery·Matthew K WhalinRishi Gupta
Mar 11, 2011·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Jan 27, 2017·Journal of Intensive Care Medicine·Kendra J SchomerErin L Louie
Jul 17, 2018·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Andrew M Slupe, Jeffrey R Kirsch
Oct 27, 2018·Journal of Neurosurgical Anesthesiology·Nan LinAdrian W Gelb
Nov 19, 2011·Critical Care Medicine·Deepak Sharma, Monica S Vavilala
Sep 29, 2020·Anesthesiology·Deepak Sharma
Feb 5, 2011·Current Opinion in Anaesthesiology·Arash FarahvarPeter J Papadakos
Feb 18, 2016·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.