| The Effectiveness and Safety of Monitored Anesthesia Using Dexmedetomidine during Intracranial Aneurysm Coiling in Elderly Patients |
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Kwang-Jin Lee , Dae-Won Kim , Sung-Don Kang |
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Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea |
| 노인 환자에서 뇌동맥류 코일 중 Dexmedetomidine을 사용한 감시 마취의 효율성과 안정성 |
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이광진·김대원·강성돈 |
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원광대학교 의과대학 원광의과학 연구소 신경외과학교실 |
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| Abstract |
Objective
Recently, monitored anesthesia using dexmedetomidine during coil embolization proved its usefulness in some articles. Especially, general anesthesia increase the risk of morbidity and mortality after procedure in old age. To evaluate the feasibility and safety of using dexmedetomidine in elderly patients, the authors have reviewed our clinical experience.
Methods
Twenty-seven elderly patients (≥65 years old) undergoing coil embolization for cerebral aneurysms under monitored anesthesia using dexmedetomidine between January 2013 and August 2015 were enrolled in this retrospective study. Vital signs of the patient were checked every 10 minutes. Depth of sedation was measured by Ramsay sedation scale and satisfaction of patients was measured by Likert verbal rating scale after 24 hours. Post-operative cognitive function was evaluated by Mini-Mental Status Examination (MMSE) after one day after procedure.
Results
Under monitored anesthesia using dexmedetomidine, vital signs of the patients were stable, no significance variation regarding hemodynamic and respiratory parameters was observed between time points. Adequate sedation was achieved. Mean Ramsay sedation scale was 3.25±0.90 (Range 2 to 6). The mean maintenance dosage of drug for adequate sedation for the procedure was 0.48±0.11mcg/kg/hr. Mean Likert verbal rating scale was 6.30±0.67 (Range 5 to 7). There was no significant change in MMSE between pre and post-procedure.
Conclusion
Embolization of the intracranial aneurysms with monitored anesthesia using dexmedetomidine appeared to be safe and feasible in elderly patient. Differently with other drugs, there was no respiratory depression. In elderly patient, local anesthesia with dexmedetomidine should be considered as alternative, when general anesthesia is not suitable |
| Key Words:
DexmedetomidineㆍCoilㆍAneurysmㆍElderlyㆍMonitored anesthesia |
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