Download PDF
Journal of Pediatric Neurology 2020; 18(03): 157-160
DOI: 10.1055/s-0039-1687882
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Dexmedetomidine for Postoperative Sedation Following Stereotactic Lead Placement

Hope Xu    *
1   Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital at Mount Sinai, New York, New York, United States
,
Anthony H. Bui   *
1   Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital at Mount Sinai, New York, New York, United States
,
Maite La Vega-Talbott
2   Department of Neurology, Pediatric Neurology, Kravis Children's Hospital at Mount Sinai, New York, New York, United States
,
Sheemon P. Zackai
3   Department of Pediatrics, Pediatric Critical Care Medicine, Kravis Children's Hospital at Mount Sinai, New York, New York, United States
› Author Affiliations
Further Information

Publication History

15 January 2019

18 March 2019

Publication Date:
30 April 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Dexmedetomidine has become an increasingly popular alternative to benzodiazepines and opioids as a safe agent for sedation and pain control, especially in pediatric populations. In this study, we present a case of postoperative use of dexmedetomidine in a pediatric patient, with a known history of behavioral difficulties, who underwent stereotactic lead placement for medically refractory epilepsy.

Keywords

dexmedetomidine - Precedex - stereoelectroencephalography - stereotactic lead placement - epilepsy - sedation

* Equal contribution


 

  • References

  • 1 Lüders HO, Najm I, Nair D, Widdess-Walsh P, Bingman W. The epileptogenic zone: general principles. Epileptic Disord 2006; 8 (Suppl. 02) S1-S9
    PubMedSearch in Google Scholar
  • 2 Chabardes S, Abel TJ, Cardinale F, Kahane P. Commentary: understanding stereoelectroencephalography: what's next?. Neurosurgery 2018; 82 (01) E15-E16
    CrossrefPubMedSearch in Google Scholar
  • 3 Avanzini G. Discussion of stereoelectroencephalography. Acta Neurol Scand Suppl 1994; 152: 70-73
    PubMedSearch in Google Scholar
  • 4 Bancaud J, Dell MB. Technics and method of stereotaxic functional exploration of the brain structures in man (cortex, subcortex, central gray nuclei) [article in French]. Rev Neurol (Paris) 1959; 101: 213-227
    PubMedSearch in Google Scholar
  • 5 Cossu M, Chabardès S, Hoffmann D, Lo Russo G. [Presurgical evaluation of intractable epilepsy using stereo-electro-encephalography methodology: principles, technique and morbidity]. Neurochirurgie 2008; 54 (03) 367-373
    CrossrefPubMedSearch in Google Scholar
  • 6 Gonzalez-Martinez J, Mullin J, Vadera S. , et al. Stereotactic placement of depth electrodes in medically intractable epilepsy. J Neurosurg 2014; 120 (03) 639-644
    CrossrefPubMedSearch in Google Scholar
  • 7 Sacino MF, Huang SS, Schreiber J, Gaillard WD, Oluigbo CO. Is the use of stereotactic electroencephalography safe and effective in children? A meta-analysis of the use of stereotactic electroencephalography in comparison to subdural grids for invasive epilepsy monitoring in pediatric subjects. Neurosurgery 2019; 84 (06) 1190-1200
    CrossrefPubMedSearch in Google Scholar
  • 8 Short JA, Calder A. Anaesthesia for children with special needs, including autistic spectrum disorder. Contin Educ Anaesth Crit Care Pain 2013; 13 (04) 107-112
    CrossrefPubMedSearch in Google Scholar
  • 9 Vlassakova BG, Emmanouil DE. Perioperative considerations in children with autism spectrum disorder. Curr Opin Anaesthesiol 2016; 29 (03) 359-366
    CrossrefPubMedSearch in Google Scholar
  • 10 Gupta S, Singh D, Sood D, Kathuria S. Role of dexmedetomidine in early extubation of the intensive care unit patients. J Anaesthesiol Clin Pharmacol 2015; 31 (01) 92-98
    CrossrefPubMedSearch in Google Scholar
  • 11 Hammer GB, Drover DR, Cao H. , et al. The effects of dexmedetomidine on cardiac electrophysiology in children. Anesth Analg 2008; 106 (01) 79-83
    CrossrefPubMedSearch in Google Scholar
  • 12 Jessen Lundorf L, Korvenius Nedergaard H, Møller AM. Perioperative dexmedetomidine for acute pain after abdominal surgery in adults. Cochrane Database Syst Rev 2016; 2: CD010358
    PubMedSearch in Google Scholar
  • 13 Lee HS, Yoon HY, Jin HJ, Hwang SH. Can dexmedetomidine influence recovery profiles from general anesthesia in nasal surgery?. Otolaryngol Head Neck Surg 2018; 158 (01) 43-53
    CrossrefPubMedSearch in Google Scholar
  • 14 Massad IM, Mohsen WA, Basha AS, Al-Zaben KR, Al-Mustafa MM, Alghanem SM. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery. Saudi Med J 2009; 30 (12) 1537-1541
    PubMedSearch in Google Scholar
  • 15 Duan X, Coburn M, Rossaint R, Sanders RD, Waesberghe JV, Kowark A. Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. Br J Anaesth 2018; 121 (02) 384-397
    CrossrefPubMedSearch in Google Scholar
  • 16 Piao G, Wu J. Systematic assessment of dexmedetomidine as an anesthetic agent: a meta-analysis of randomized controlled trials. Arch Med Sci 2014; 10 (01) 19-24
    PubMedSearch in Google Scholar
  • 17 Ahmed SS, Unland T, Slaven JE, Nitu ME, Rigby MR. Successful use of intravenous dexmedetomidine for magnetic resonance imaging sedation in autistic children. South Med J 2014; 107 (09) 559-564
    CrossrefPubMedSearch in Google Scholar
  • 18 Franklin AD, Sobey JH, Stickles ET. Anesthetic considerations for pediatric electroconvulsive therapy. Paediatr Anaesth 2017; 27 (05) 471-479
    CrossrefPubMedSearch in Google Scholar
  • 19 Koroglu A, Demirbilek S, Teksan H, Sagir O, But AK, Ersoy MO. Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. Br J Anaesth 2005; 94 (06) 821-824
    CrossrefPubMedSearch in Google Scholar
  • 20 De Benedictis A, Trezza A, Carai A. , et al. Robot-assisted procedures in pediatric neurosurgery. Neurosurg Focus 2017; 42 (05) E7
    PubMedSearch in Google Scholar
  • 21 Xu KL, Liu XQ, Yao YL. , et al. Effect of dexmedetomidine on rats with convulsive status epilepticus and association with activation of cholinergic anti-inflammatory pathway. Biochem Biophys Res Commun 2018; 495 (01) 421-426
    CrossrefPubMedSearch in Google Scholar
  • 22 Zhai MZ, Wu HH, Yin JB. , et al. Dexmedetomidine dose-dependently attenuates ropivacaine-induced seizures and negative emotions via inhibiting phosphorylation of amygdala extracellular signal-regulated kinase in mice. Mol Neurobiol 2016; 53 (04) 2636-2646
    CrossrefPubMedSearch in Google Scholar
  • 23 Tanaka K, Oda Y, Funao T, Takahashi R, Hamaoka N, Asada A. Dexmedetomidine decreases the convulsive potency of bupivacaine and levobupivacaine in rats: involvement of alpha2-adrenoceptor for controlling convulsions. Anesth Analg 2005; 100 (03) 687-696
    CrossrefPubMedSearch in Google Scholar
  • 24 Talke P, Stapelfeldt C, Garcia P. Dexmedetomidine does not reduce epileptiform discharges in adults with epilepsy. J Neurosurg Anesthesiol 2007; 19 (03) 195-199
    CrossrefPubMedSearch in Google Scholar
  • 25 Chaitanya G, Arivazhagan A, Sinha S. , et al. Dexmedetomidine anesthesia enhances spike generation during intra-operative electrocorticography: a promising adjunct for epilepsy surgery. Epilepsy Res 2015; 109: 65-71
    CrossrefPubMedSearch in Google Scholar
  • 26 Souter MJ, Rozet I, Ojemann JG. , et al. Dexmedetomidine sedation during awake craniotomy for seizure resection: effects on electrocorticography. J Neurosurg Anesthesiol 2007; 19 (01) 38-44
    CrossrefPubMedSearch in Google Scholar
  • 27 Ard J, Doyle W, Bekker A. Awake craniotomy with dexmedetomidine in pediatric patients. J Neurosurg Anesthesiol 2003; 15 (03) 263-266
    CrossrefPubMedSearch in Google Scholar
  • 28 Fernandes ML, do Carmo Santos M, Gomez RS. Sedation with dexmedetomidine for conducting electroencephalogram in a patient with Angelman syndrome: a case report. Braz J Anesthesiol 2016; 66 (02) 212-214
    PubMedSearch in Google Scholar
  • 29 Takahashi Y, Ueno K, Ninomiya Y, Eguchi T, Nomura Y, Kawano Y. Potential risk factors for dexmedetomidine withdrawal seizures in infants after surgery for congenital heart disease. Brain Dev 2016; 38 (07) 648-653
    CrossrefPubMedSearch in Google Scholar
  • 30 Ghai B, Jain K, Saxena AK, Bhatia N, Sodhi KS. Comparison of oral midazolam with intranasal dexmedetomidine premedication for children undergoing CT imaging: a randomized, double-blind, and controlled study. Paediatr Anaesth 2017; 27 (01) 37-44
    CrossrefPubMedSearch in Google Scholar
  • 31 Mahmoud M, Gunter J, Donnelly LF, Wang Y, Nick TG, Sadhasivam S. A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children. Anesth Analg 2009; 109 (03) 745-753
    CrossrefPubMedSearch in Google Scholar
  • 32 Qiao H, Xie Z, Jia J. Pediatric premedication: a double-blind randomized trial of dexmedetomidine or ketamine alone versus a combination of dexmedetomidine and ketamine. BMC Anesthesiol 2017; 17 (01) 158
    CrossrefPubMedSearch in Google Scholar
  • 33 Mason KP, Zgleszewski S, Forman RE, Stark C, DiNardo JA. An exaggerated hypertensive response to glycopyrrolate therapy for bradycardia associated with high-dose dexmedetomidine. Anesth Analg 2009; 108 (03) 906-908
    CrossrefPubMedSearch in Google Scholar
  • 34 Buck ML, Willson DF. Use of dexmedetomidine in the pediatric intensive care unit. Pharmacotherapy 2008; 28 (01) 51-57
    CrossrefPubMedSearch in Google Scholar
  • 35 Guinter JR, Kristeller JL. Prolonged infusions of dexmedetomidine in critically ill patients. Am J Health Syst Pharm 2010; 67 (15) 1246-1253
    CrossrefPubMedSearch in Google Scholar
  • 36 Miller JL, Allen C, Johnson PN. Neurologic withdrawal symptoms following abrupt discontinuation of a prolonged dexmedetomidine infusion in a child. J Pediatr Pharmacol Ther 2010; 15 (01) 38-42
    PubMedSearch in Google Scholar