Open AccessIntraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease
Author(s) -
Hyungseok Seo,
Ho Geol Ryu,
Je Do Son,
Jeong Soo Kim,
Eun Jin Ha,
Jeong Eun Kim,
Hee Pyoung Park
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000005712
Subject(s) - medicine , dexmedetomidine , moyamoya disease , middle cerebral artery , anesthesia , incidence (geometry) , anastomosis , surgery , ischemia , superficial temporal artery , revascularization , sedation , physics , myocardial infarction , optics
Dexmedetomidine, a selective α 2 -agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively ( P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease.