• Cristina Honorato-Cia, Antonio Martínez-Simón, Manuel Alegre, Jorge Guridi, Elena Cacho-Asenjo, Alfredo Panadero, and Jorge M Núñez-Córdoba.
• Department of Anesthesiology and Critical Care, University Hospital Navarra, Pamplona, Spain.
• Stereotact Funct Neurosurg. 2015 Jan 1; 93 (6): 393-9.

IntroductionDexmedetomidine 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.MethodsWe 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.Results14 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].ConclusionDexmedetomidine 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.© 2015 S. Karger AG, Basel.

18 keywords...

hide…