Perioperative Medicine  |   June 2017
Effect of Dexmedetomidine and Propofol on Basal Ganglia Activity in Parkinson Disease: A Controlled Clinical Trial
Author Notes
  • From the Department of Anesthesia, Perioperative Medicine and Critical Care (A.M.-S., C.H-C., E.C.-A.), Department of Neurophysiology (M.A.), Research Support Service, Central Clinical Trials Unit (J.M.N.-C), Department of Neurology (M.C.-A.), and Department of Neurosurgery (J.G.), University of Navarra Clinic, Pamplona, Spain; and Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy and Nutrition (I.F.T.) and Neurophysiology Laboratory, Center for Applied Medical Research (M.V.), University of Navarra, Pamplona, Spain.
  • Submitted for publication June 30, 2016. Accepted for publication February 21, 2017.
    Submitted for publication June 30, 2016. Accepted for publication February 21, 2017.×
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
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    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Address correspondence to Dr. Martinez-Simon: Department of Anesthesia, Perioperative Medicine and Critical Care, University of Navarra Clinic, 36 Av. Pio XII, 31008 Pamplona, Spain. amartinezs@unav.es. This article may be accessed for personal use at no charge through the Journal Web site, www.anesthesiology.org.
Article Information
Perioperative Medicine / Clinical Science / Central and Peripheral Nervous Systems / Pharmacology
Perioperative Medicine   |   June 2017
Effect of Dexmedetomidine and Propofol on Basal Ganglia Activity in Parkinson Disease: A Controlled Clinical Trial
Anesthesiology 6 2017, Vol.126, 1033-1042. doi:10.1097/ALN.0000000000001620
Anesthesiology 6 2017, Vol.126, 1033-1042. doi:10.1097/ALN.0000000000001620
Abstract

Background: Deep brain stimulation electrodes can record oscillatory activity from deep brain structures, known as local field potentials. The authors’ objective was to evaluate and quantify the effects of dexmedetomidine (0.2 μg·kg-1·h-1) on local field potentials in patients with Parkinson disease undergoing deep brain stimulation surgery compared with control recording (primary outcome), as well as the effect of propofol at different estimated peak effect site concentrations (0.5, 1.0, 1.5, 2.0, and 2.5 μg/ml) from control recording.

Methods: A nonrandomized, nonblinded controlled clinical trial was carried out to assess the change in local field potentials activity over time in 10 patients with Parkinson disease who underwent deep brain stimulation placement surgery (18 subthalamic nuclei). The relationship was assessed between the activity in nuclei in the same patient at a given time and repeated measures from the same nucleus over time.

Results: No significant difference was observed between the relative beta power of local field potentials in dexmedetomidine and control recordings (−7.7; 95% CI, −18.9 to 7.6). By contrast, there was a significant decline of 12.7% (95% CI, −21.3 to −4.7) in the relative beta power of the local field potentials for each increment in the estimated peak propofol concentrations at the effect site relative to the control recordings.

Conclusions: Dexmedetomidine (0.2 μg·kg-1·h-1) did not show effect on local field potentials compared with control recording. A significant deep brain activity decline from control recording was observed with incremental doses of propofol.