Awake Craniotomy In Brain Glioma Resection-a Comparison Between Dexmedetomidine And Innovar

ObjectiveTo compare the effect of Dexmedetomidine and Innovar in the wake-up period of brain glioma resection and to provide scientific basis for the selection of intraoperative awakening of drugs.MethodsForty patients requiring the intraoperative awakening in brain glioma resection to determine the location of cerebral cortex functional areas were selected and randomly divided into Dexmedetomidine Group(Group D)and Innovar group(Group F),each group had 20 cases.Patients in two groups underwent Propofol,Remifentanil general anesthesia induction and the laryngeal masks were used to control ventilation.The infusion of Propofol,Remifentanil was stopped 15 minutes before the electrophysiological monitoring was performed,patients in Group F were intravenously injected with a loading dose of 100ug Fentanyl and 5mg Droperidol,followed by Fentanyl 100ug/h,Droperidol 5mg/h continuous pump maintenance;Patients in Group D were intravenously injected with a loading dose of 0.5ug/kg Dexmedetomidine,followed by 0.3ug/kg/h-0.5ug/kg/h Dexmedetomidine continuous infusion maintenance.After the recovery of their autonomous respiration,the laryngeal masks were removed and their movement,feeling and language function were assessed.After the tumor resection,the anesthesia induction was performed again into the laryngeal masks,followed by the continuous infusion of Propofol,Remifentanil,until the end of surgery.In this experiment,the main observation indicators were Observer's Assessment of Alertness/Sedation(OAA/S)scales,Numerical Rating scales(NRS),eloquent brain areas mapping status,wake-up time.Time points of observing the intraoperative vital signs:Intraoperative Baseline(TO),Stop infusion of propofol instantly(T1),wake up(T2),wake up after 5min(T3),wake up after lOmin(T4),wake up after 15min(T5),wake up after 30min(T6),wake up after 60min(T7).The MAP,HR and Sp02 at each time point were recorded.Respiratory depression,nausea and vomiting,and other adverse reactions were observed.Data was processed with SPSS 19.0,the normal distribution data was statistically described in mean ± standard deviation,and the measurement data was ideated in value and percentage(%).Two independent sample t-test was performed on the basic characteristics,intraoperative vital signs and measurement data,the incidence rates of intraoperative adverse events were counted using chi-square test;NRS,OAA/S,and eloquent brain areas mapping status were scored using two independent sample nonparametric test(Mann-WhitneyU test).When P<0.05,difference was statistically significant.Results1.There were no significant differences in gender,age,height,weight and body mass index between the two groups(P>0.05);2.Compared with Group F,the blood pressure,heart rate and wake-up time in Group D was significantly lower(P<0.05),but there were no significant differences in OAA/S scales,NRS,eloquent brain areas mapping status;3.There was no significant difference in the incidence rate of adverse events(P>0.05).Conclusion1.Both Dexmedetomidine and Innovar can be successfully used in functional areas of glioma surgery to wake anesthesia.2.The dexmedetomidine group had a short wake-up time and more stable hemodynamics during intraoperative wake-up.