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Comparative effects...
Comparative effects of dexmedetomidine, propofol, sevoflurane, and S-ketamine on regional cerebral glucose metabolism in humans : a positron emission tomography study
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- Laaksonen, L. (author)
- University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland
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- Kallioinen, M. (author)
- Turku University Hospital, Turku, Finland
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- Löngsjö, J. (author)
- Tampere University Hospital, Tampere, Finland
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- Laitio, T. (author)
- Turku University Hospital, Turku, Finland
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- Scheinin, A. (author)
- University of Turku. Turku, Finland / Turku University Hospital, Turku, Finland
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- Scheinin, J. (author)
- Kuopio University Hospital, Kuopio, Finland
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- Kaisti, K. (author)
- Oulu University Hospital, Oulu, Finland
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- Maksimow, A. (author)
- Turku University Hospital, Turku, Finland,University of California, Irvine, CA, USA
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- Kallionpää, R. E. (author)
- Turku University Hospital, Turku, Finland / University of Turku, Turku, Finland
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- Rajala, V. (author)
- Turku University Hospital, Turku, Finland
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- Johansson, Jarkko (author)
- Umeå universitet,Diagnostisk radiologi,Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland,University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland / Umeå University, Umeå, Sweden
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- Kantonen, O. (author)
- University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland / University of California, Irvine, CA, USA
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- Nyman, M. (author)
- Turku University Hospital, Turku, Finland
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- Sirén, S. (author)
- Turku University Hospital, Turku, Finland
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- Valli, Katja, 1973- (author)
- Högskolan i Skövde,Institutionen för biovetenskap,Forskningscentrum för Systembiologi,Turku University Hospital, Turku, Finland / University of Turku, Turku, Finland,Consciousness and Cognitive Neuroscience
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- Revonsuo, Antti (author)
- Högskolan i Skövde,Institutionen för biovetenskap,Forskningscentrum för Systembiologi,University of Turku, Turku, Finland,Consciousness and Cognitive Neurosciece
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- Solin, O. (author)
- University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland
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- Vahlberg, T. (author)
- University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland
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Alkire, M. (author)
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- Scheinin, H. (author)
- University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland
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(creator_code:org_t)
- Elsevier, 2018
- 2018
- English.
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In: British Journal of Anaesthesia. - : Elsevier. - 0007-0912 .- 1471-6771. ; 121:1, s. 281-290
- Related links:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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http://bjanaesthesia...
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https://his.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Introduction: The 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.Methods: One 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.Results: At 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 (P<0.001 between the groups). The lowest CMRglu was observed in nearly all brain regions with dexmedetomidine (P<0.05 compared with all other groups). With S-ketamine, CMRglu did not differ from placebo.Conclusions: At equi-sedative doses in humans, potency in reducing CMRglu was dexmedetomidine>propofol>ketamine=placebo. These findings alleviate concerns for dexmedetomidine-induced vasoconstriction and cerebral ischaemia.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)
Keyword
- cerebral blood flow
- cerebral metabolism
- positron emission tomography
- sedation
- target-controlled infusion
- Consciousness and Cognitive Neuroscience
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Laaksonen, L.
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Kallioinen, M.
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Löngsjö, J.
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Laitio, T.
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Scheinin, A.
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Scheinin, J.
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Kaisti, K.
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Maksimow, A.
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Kallionpää, R. E ...
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Rajala, V.
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Johansson, Jarkk ...
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Kantonen, O.
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Nyman, M.
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Sirén, S.
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Valli, Katja, 19 ...
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Revonsuo, Antti
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Solin, O.
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Vahlberg, T.
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Alkire, M.
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Scheinin, H.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Other Medical an ...
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and Other Medical an ...
- Articles in the publication
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British Journal ...
- By the university
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Umeå University
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University of Skövde