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Effect of Dexmedetomidine versus Propofol on Intraoperative Seizure Onset During Awake Craniotomy: A Retrospective Study.
Deana, Cristian; Pez, Sara; Ius, Tamara; Furlan, Davide; Nilo, Annacarmen; Isola, Miriam; De Martino, Maria; Mauro, Stefano; Verriello, Lorenzo; Lettieri, Christian; Tomasino, Barbara; Valente, Mariarosaria; Skrap, Miran; Vetrugno, Luigi; Pauletto, Giada.
Afiliación
  • Deana C; 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.
  • Pez S; Department of Medicine, University of Udine, Udine, Italy.
  • Ius T; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy; Department of Neuroscience, Mental Health and Sense Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
  • Furlan D; Department of Medicine, University of Udine, Udine, Italy.
  • Nilo A; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Isola M; Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy.
  • De Martino M; Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy.
  • Mauro S; Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Verriello L; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Lettieri C; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Tomasino B; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy; Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy.
  • Valente M; Department of Medicine, University of Udine, Udine, Italy; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Skrap M; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
  • Vetrugno L; Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University of Chieti-Pescara, Chieti, Italy.
  • Pauletto G; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
World Neurosurg ; 172: e428-e437, 2023 Apr.
Article en En | MEDLINE | ID: mdl-36682527
OBJECTIVE: The 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. METHODS: In 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. RESULTS: Of 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. CONCLUSIONS: IOSs 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propofol / Dexmedetomidina / Epilepsia Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propofol / Dexmedetomidina / Epilepsia Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos