• World Neurosurg · Apr 2023

    EFFECT OF DEXMEDETOMIDINE VERSUS PROPOFOL ON INTRAOPERATIVE SEIZURE ONSET DURING AWAKE CRANIOTOMY: A RETROSPECTIVE STUDY.

    • Cristian Deana, Sara Pez, Tamara Ius, Davide Furlan, Annacarmen Nilo, Miriam Isola, Maria De Martino, Stefano Mauro, Lorenzo Verriello, Christian Lettieri, Barbara Tomasino, Mariarosaria Valente, Miran Skrap, Luigi Vetrugno, and Giada Pauletto.
    • Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy. Electronic address: cristian.deana@asufc.sanita.fvg.it.
    • World Neurosurg. 2023 Apr 1; 172: e428e437e428-e437.

    ObjectiveThe effect of dexmedetomidine (DEX) compared with propofol on intraoperative seizures (IOSs) detected using electrocorticography during awake craniotomy for resection of brain tumors is unknown. This investigation aimed to compare IOS rate in patients receiving DEX versus propofol as sedative agent.MethodsIn this retrospective single-center study, awake craniotomies performed from January 2014 to December 2019 were analyzed. All IOSs detected by electrocorticography along with vital signs were recorded.ResultsOf 168 adults enrolled in the study, 58 were administered DEX and 110 were administered propofol. IOSs occurred more frequently in the DEX group (22%) versus the propofol group (11%) (P = 0.046). A higher incidence of bradycardia was also observed in the DEX group (P < 0.001). Higher incidence of hypertension and a higher mean heart rate were recorded in the propofol group (P = 0.006 and P < 0.001, respectively). No serious adverse events requiring active drug administration were noted in either group. At univariate regression analysis, DEX demonstrated a tendency to favor IOS onset but without statistical significance (odds ratio = 2.36, P = 0.051). Patients in both groups had a similar epilepsy outcome at the 1-year postoperative follow-up.ConclusionsIOSs detected with electrocorticography during awake craniotomy occurred more frequently in patients receiving DEX than propofol. However, patients receiving DEX were not shown to be at a statistically significant greater risk for IOS onset. DEX is a valid alternative to propofol during awake craniotomy in patients affected by tumor-related epilepsy.Copyright © 2023 Elsevier Inc. All rights reserved.

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