Usefulness of Dexmedetomidine during Intracerebral Aneurysm Coiling

Title
Usefulness of Dexmedetomidine during Intracerebral Aneurysm Coiling
Author(s)
이현호정영진최병연장철훈
Keywords
INTENSIVE-CARE-UNIT; INTERVENTIONAL NEURORADIOLOGY; INTRAVENOUS DEXMEDETOMIDINE; ENDOVASCULAR TREATMENT; SEDATION; SURGERY; PROPOFOL; EFFICACY; INFUSION; HUMANS
Issue Date
201404
Publisher
KOREAN NEUROSURGICAL SOC
Citation
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, v.55, no.4, pp.185 - 189
Abstract
Objective : General anesthesia is often preferred for endovascular coiling of intracranial aneurysm at most centers. But in the authors' hospital, it is performed under monitored anesthesia care (MAC) using dexmedetomidine. To determine the feasibility and safety of this approach, the authors reviewed our initial experience. Methods : Retrospective data was analyzed from July 2012 to November 2012. We performed coil embolization in 28 cases using this method. Among them, for statistical significance, we analyzed 12 cases in which the procedure time exceeded an hour. Vital signs were analyzed every 10 minutes. Depth of sedation was measured according to the Ramsay sedation scale and frequency of the repeated roadmap image(s) caused by movement of the patient's head during the procedure. Results : All procedures were completed without occurrence of procedure related complications. Under MAC using dexmedetomidine, vital signs of the patients were stable, no statistical significance regarding hemodynamic and respiratory parameters was observed between time points (p>0.05). Adequate sedation was achieved. Mean Ramsay sedation scale was 3.67 +/- 1.61 (2 to 6). Repeated roadmap image(s) due to patient's factor occurred in only one case. The mean dosage of drug for adequate sedation for the procedure was 0.65 +/- 0.12 mcg/kg/hr without loading doses. Conclusion : To the best of my knowledge, this is the first report published in English using the method of monitored anesthesia with dexmedetomidine for intracranial aneurysm coiling. Monitored anesthesia care using dexmedetomidine without loading dose for embolization of intracranial aneurysms appeared to be a safe and effective alternative to general anesthesia.
URI
http://hdl.handle.net/YU.REPOSITORY/32630http://dx.doi.org/10.3340/jkns.2014.55.4.185
ISSN
2005-3711
Appears in Collections:
의과대학 > 영상의학과학교실 > Articles
의과대학 > 신경외과학교실 > Articles
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