Comparison of dexmedetomidine and propofol for sedation in awake craniotomy: A meta-analysis

被引:15
作者
Viderman, Dmitriy [1 ,4 ]
Nabidollayeva, Fatima [2 ]
Bilotta, Federico [3 ]
Abdildin, Yerkin G. [2 ,5 ]
机构
[1] Nazarbayev Univ, Sch Med NUSOM, Zhanibek Khans Str 5-1, Astana, Kazakhstan
[2] Nazarbayev Univ, Sch Engn & Digital Sci, 53 Kabanbay Batyr Ave, Astana 010000, Kazakhstan
[3] Univ Sapienza, Dept Anesthesia & Intens Care, Rome, Italy
[4] Natl Res Oncol Ctr, Dept Anesthesiol Intens Care & Pain Med, Kerey & Zhanibek Khans Str 3, Astana 020000, Kazakhstan
[5] Nazarbayev Univ, Sch Engn & Digital Sci, 53 Kabanbay Batyr Ave,29, Astana 010000, Kazakhstan
关键词
Awake craniotomy; Asleep -awake -asleep anesthesia; Dexmedetomidine; Propofol; Conscious sedation; REMIFENTANIL CONSCIOUS SEDATION; ANESTHESIA; NEUROSURGERY; PATIENT;
D O I
10.1016/j.clineuro.2023.107623
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Awake craniotomy (AC) is the preferred option for the resection of tumors adjacent to eloquent cortical areas and in cases of intractable epilepsy. It is mostly used to maintain the integrity of the brain during intracranial neurosurgical procedures. Awake craniotomy requires the use of ideal anesthetics, hypnotics, and analgesics to balance sedation, prompt the reversal of sedation, and prevent respiratory depression while maintaining communication between patient and medical team. Although a wide variety of anesthetics and hypnotics have been used for awake craniotomy over the past several decades, the optimal drug for the pro-cedure has yet to be determined. The purpose of this meta-analysis was to compare dexmedetomidine and propofol in terms of intraoperative adverse events (i.e., hypertension, hypotension, nausea, vomiting, respiratory depression), patient and surgeon satisfaction, and procedure duration.Methods: We searched PubMed, Google Scholar, and the Cochrane Library for relevant articles published between the inception of these databases and April of 2022. The systematic search yielded 781 articles. After screening, we excluded 778 articles. The remaining three articles reporting 138 patients were selected for meta-analysis. Results: This meta-analysis showed no statistically significant difference between propofol and dexmedetomidine related to intraoperative adverse events, patient satisfaction, or procedure duration. The only statistically sig-nificant result was surgeon satisfaction, which appeared to be higher in the dexmedetomidine group.Conclusions: Further high-quality randomized and controlled trials are needed to find a preferred agent for intraoperative sedation in awake craniotomy.
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页数:7
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