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NEUROSURGICAL ANESTHESIA

Clinical Experience with Dexmedetomidine for Implantation of Deep Brain Stimulators in Parkinson's Disease

Irene Rozet, MD^*, Saipin Muangman, MD^*, Monica S. Vavilala, MD^*, Lorri A. Lee, MD^*, Michael J. Souter, MB, ChB, FRCA^*, Karen J. Domino, MD^*, Jefferson C. Slimp, PhD, Robert Goodkin, MD, and Arthur M. Lam, MD, FRCPC^*

From the Departments of *Anesthesiology, Pediatrics, Rehabilitation Medicine, and Neurological Surgery, University of Washington, Seattle, Washington.

Address correspondence and reprint requests to Irene Rozet, MD, Assistant Professor, Harborview Medical Center, Box 359724, 325 Ninth Ave., Seattle, Washington 98104-2499. Address e-mail to i_rozet{at}hotmail.com.

The pharmacologic profile of the -2 agonist dexmedetomidine (Dex) suggests that it may be an ideal sedative drug for deep brain stimulator (DBS) implantation. We performed a retrospective chart review of anesthesia records of patients who underwent DBS implantation from 2001 to 2004. In 2003, a clinical protocol with Dex sedation for DBS implantation was initiated. Demographic data, use of antihypertensive medication, and duration of mapping were compared between patients who received Dex (11 patients/13 procedures) and patients who did not receive any sedation (controls: 8 patients/9 procedures). There were no differences in severity of illness between the two groups. Dex provided patient comfort and surgical satisfaction with mapping in all cases, and significantly reduced the use of antihypertensive medication (54% in the Dex group, versus 100% in controls, P = 0.048). In DBS implantation, sedation with Dex did not interfere with electrophysiologic mapping, and provided hemodynamic stability and patient comfort. Routine use of Dex in these procedures may be indicated.

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