Effect of supplemental dexmedetomidine in interventional embolism on cerebral oxygen metabolism in patients with intracranial aneurysms

Abstract

Objective: To investigate the effect of supplemental dexmedetomidine in interventional embolism on cerebral oxygen metabolism in patients with intracranial aneurysms.

Methods: Ninety patients who underwent interventional embolism of intracranial aneurysms were equally divided into Group A and Group B. In Group A, dexmedetomidine was injected intravenously 10 minutes before inducing anesthesia, with a loading dose of 0.6 µg/kg followed by 0.4 µg/kg/hour. Group B received the same amount of normal saline by the same injection method. Heart rate (HR), mean arterial pressure (MAP), arterial-jugular venous oxygen difference [D(a-jv) (O₂)], cerebral oxygen extraction [CE (O₂)], and intraoperative propofol use were recorded before inducing anesthesia (T₀) and at five time points thereafter.

Results: The amount of propofol in Group A was lower vs Group B. At all five time points after T₀, HR, MAP, D(a-jv) (O₂), and CE (O₂) in Group A were significantly lower vs Group B, with significant differences for jugular venous oxygen saturation (S_jvO₂) and the oxygen content of the internal jugular vein (C_jvO₂) between the groups.

Conclusion: Dexmedetomidine resulted in less intraoperative propofol, lower D(a-jv) (O₂) and CE (O₂), and improved cerebral oxygen metabolism.

Keywords: Dexmedetomidine; anesthesia; arterial–jugular venous oxygen difference [D(a-jv) (O2)]; cerebral extraction of oxygen [CE (O2)]; intracranial aneurysm; propofol; surgery.

Figure 1.

Flowchart of patients participating in the study. BMI, body mass index; ASA, American Society of Anesthesiologists; HR, heart rate; MAP, mean arterial pressure.