Uso de dexmedetomidina em neurocirurgia

Abstract

The pharmacokinetic and pharmacodynamic profile of dexmedetomidine favors its use in several neurosurgical procedures. Its use in craniotomy for the treatment of aneurysms and tumor removal is recent. Besides, its use in functional surgical interventions is promising.

Intraoperative Dexmedetomidine Maintains Hemodynamic Stability and Hastens Postoperative Recovery in Patients Undergoing Transsphenoidal Pituitary Surgery

“…By virtue of its α-2 agonist actions that inhibit noradrenergic transmission, Dex reduces the requirement of inhalational anesthetic agents. 9 In our study too, Dex reduced the MAC of sevoflurane by 14%, which is in consonance with the previous studies. 20 21 We monitored anesthetic depth with BIS, an accepted tool for monitoring depth of anesthesia.…”

“…It has established itself as a useful anesthetic adjuvant because it produces anxiolysis, reduces requirements of inhalational anesthetics as well as opioids, and is devoid of respiratory depression in the postoperative period. 8 9…”

Cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone or in combination with methadone, morphine or tramadol in dogs

“…The effects of α 2 ‐adrenergic agonists on blood pressure are defined by two stages, an initial phase characterized by peripheral vasoconstriction, increased blood pressure and reflex bradycardia, and another subsequent phase with a reduction of sympathetic tone and hypotension (Hebert et al. ; Lee ). There was little effect noted on SAP in this study but the baseline values were higher than would be expected in normal dogs and this may have influenced our subsequent results.…”

“…), and in human patients, provides sedation at low doses without observing the cardiovascular effects caused by the activation of the vascular α receptors (Hebert et al. ).…”

Feature Extraction and Small-Sample Learning of Dexmedetomidine for Neurosurgery on Postoperative Agitation in Patients with Craniocerebral Injury

“…Some scholars believe that it may be related to the different degrees of suppression of the central nervous system by anaesthetic drugs; such patients may have recovered consciousness during the awakening period of general anaesthesia, but due to the residual effects of some anaesthetic drugs, the patient's cerebral cortex is still suppressed, while their subcutaneous central functions have been restored. This inconsistent neurological state results in a lack of functional integrity of the brain, which ultimately leads to a state of central nervous system hyperexcitability [ 12 ]. This lack of functional integrity can take many forms, for example, after awakening from anaesthesia, the patient is generally quiet and drowsy, with a small number of patients having mild disorientation and a gradual normalisation of the functional brain response from blurred or sluggish, but a few of these susceptible patients can be agitated (reflexively antagonised) by any adverse stimulus (pain, distress, or discomfort) during the period of blurred or sluggish functional brain response [ 13 ].…”