Comparative effects of dexmedetomidine, propofol, sevoflurane, and S-ketamine on regional cerebral glucose metabolism in humans: a positron emission tomography study
| Autor: | Jarkko Johansson, Tero Vahlberg, J. Scheinin, Olof Solin, Annalotta Scheinin, K. Kaisti, Timo Laitio, Oskari Kantonen, Michael T. Alkire, Mikko Nyman, Minna Kallioinen, Roosa E. Kallionpää, Jaakko Långsjö, Saija Sirén, Lauri T Laaksonen, Antti Revonsuo, Harry Scheinin, Anu Maksimow, Katja Valli, V. Rajala |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
positron emission tomography cerebral blood flow 0302 clinical medicine 030202 anesthesiology cerebral metabolism Övrig annan medicin och hälsovetenskap Hypnotics and Sedatives Propofol medicine.diagnostic_test Brain Other Medical Sciences not elsewhere specified 3. Good health Cerebral blood flow sedation Positron emission tomography Cerebrovascular Circulation Anesthesia Anesthetics Inhalation target-controlled infusion Ketamine medicine.symptom Dexmedetomidine medicine.drug Adult Anestesi och intensivvård Adolescent medicine.drug_class Sedation Sevoflurane Young Adult 03 medical and health sciences Fluorodeoxyglucose F18 medicine Humans Brain Chemistry ta3126 Anesthetics Dissociative Anesthesiology and Intensive Care business.industry Neurointensive care Kinetics Glucose Anesthesiology and Pain Medicine Positron-Emission Tomography Sedative Radiopharmaceuticals business 030217 neurology & neurosurgery |
| Zdroj: | British Journal of Anaesthesia. 121(1):281-290 |
| ISSN: | 0007-0912 |
| Popis: | IntroductionThe highly selective α2-agonist dexmedetomidine has become a popular sedative for neurointensive care patients. However, earlier studies have raised concern that dexmedetomidine might reduce cerebral blood flow without a concomitant decrease in metabolism. Here, we compared the effects of dexmedetomidine on the regional cerebral metabolic rate of glucose (CMRglu) with three commonly used anaesthetic drugs at equi-sedative doses. MethodsOne hundred and sixty healthy male subjects were randomised to EC50 for verbal command of dexmedetomidine (1.5 ng ml−1; n=40), propofol (1.7 μg ml−1; n=40), sevoflurane (0.9% end-tidal; n=40) or S-ketamine (0.75 μg ml−1; n=20) or placebo (n=20). Anaesthetics were administered using target-controlled infusion or vapouriser with end-tidal monitoring. 18F-labelled fluorodeoxyglucose was administered 20 min after commencement of anaesthetic administration, and high-resolution positron emission tomography with arterial blood activity samples was used to quantify absolute CMRglu for whole brain and 15 brain regions. ResultsAt the time of [F18]fluorodeoxyglucose injection, 55% of dexmedetomidine, 45% of propofol, 85% of sevoflurane, 45% of S-ketamine, and 0% of placebo subjects were unresponsive. Whole brain CMRglu was 63%, 71%, 71%, and 96% of placebo in the dexmedetomidine, propofol, sevoflurane, and S-ketamine groups, respectively (Ppropofol>ketamine=placebo. These findings alleviate concerns for dexmedetomidine-induced vasoconstriction and cerebral ischaemia. CC BY-NC-ND 4.0 |
| Databáze: | OpenAIRE |
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