BMC anesthesiology
Comparison of dexmedetomidine and droperidol-fentanyl for asleep-awake-asleep techniques in awake craniotomy anesthesia: a randomized controlled study
Par Yang X, Qu D, Ren Y et 6 autres.
Contenu en anglais
Résumé
Background
In this study, we aimed to compare dexmedetomidine with droperidol-fentanyl during the intraoperative awakening phase of awake craniotomy (AC), focusing on wake-up time.
Methods
We conducted a single-center randomized controlled trial in China from January 2018 to December 2018. Patients aged 36-60 years, with American Society of Anesthesiologists physical status I-II, scheduled for brain glioma resection, were screened for eligibility; 61 were randomized, and 60 were included in the final analysis. The patients were randomized to either the dexmedetomidine group (intravenous loading dose of dexmedetomidine 0.5 µg·kg- 1 after discontinuation of propofol and remifentanil, followed by a maintenance infusion of dexmedetomidine 0.3-0.5 µg·kg- 1·h- 1) or the droperidol-fentanyl group (intravenous loading doses of fentanyl 2 µg·kg- 1 and droperidol 5 mg after discontinuation of propofol and remifentanil, followed by continuous maintenance infusions of fentanyl 2 µg·kg- 1·h- 1 and droperidol 0.1 mg·kg- 1·h- 1). A wake-up assessment was performed during maintenance of the assigned study regimen. The primary outcome measure was wake-up time. Secondary outcomes included the Observer's Assessment of Alertness/Sedation (OAA/S) scale, Numerical Rating Scale (NRS), eloquent brain area mapping status, vital signs, and adverse events.