[Application of dexmedetomidine for brain nuclei lesion of patients with Parkinson's disease].
[Application of dexmedetomidine for brain nuclei lesion of patients with Parkinson's disease].
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Original abstract
OBJECTIVE: To observe the sedative and analgesic effects of dexmedetomidine (Dex) and its influence on respiration and blood pressure, evaluate electrophysiological monitoring and explore the optimal dose of Dex for brain nuclei lesion in Parkinson's disease (PD) patients. METHODS: Approved by hospital ethics committee, 60 PD patients undergoing brain nuclei lesion ablation were randomly allocated into 3 groups (n = 20 each). No sedative anesthetic was used in group A; In group B, Dex 0.3 µg/kg intravenously for initial bolus (duration 15 min) and then 0.3 µg·kg(-1)·h(-1) continuous infusion; In group C, Dex 0.5 µg/kg intravenously (duration 15 min) for initial load and then 0.3 µg·kg(-1)·h(-1) continuous infusion. The parameters of mean arterial pressure (MAP), heart rate (HR), pressure of end-tidal carbon dioxide (P ETCO2), respiratory rate, blood oxygen saturation (SpO2), observer's assessment of alertness/sedation (OAA/S) and verbal rating score (VRS) were recorded at 0 min (baseline), 5 min (T1), 10 min (T2), 15 min (T3), 20 min (T4), 30 min (T5) and 60 min (T6) after the dosing of Dex. RESULTS: HR and respiratory rate decreased in groups B and C compared with baseline. In group C, P ETCO2 was much higher, compared with baseline (P < 0.05). Blood pressures of three groups were well-controlled. The incidence of pain (VRS ≥ 1) in group A was significantly higher than those of groups B and C (P < 0.05). And the incidence of sedation (OAA/S > 1) in group C was much higher than those of groups A and B. The electrophysiological signal of two patients in group C was severely affected. CONCLUSION: At an initial intravenous dose of Dex 0.3 µg/kg and a maintenance dose of 0.3 µg ·kg(-1)·h(-1), electrophysiological monitoring for surgery is not affected in PD patients undergoing brain nuclei lesion ablation. With a minimal interference of breath, Dex has not only well-controlled effects on sedation, analgesia and blood pressure, but also makes patients comfortable.