Effect of Dexmedetomidine on Brain Homeostasis and Neurocognitive Outcome
Status:
Recruiting
Trial end date:
2021-11-30
Target enrollment:
Participant gender:
Summary
Brain tumor surgery is commonly associated with different degrees of preoperative
intracranial hypertension and surrounding tumor edema, elicited by tumor underlying
pathophysiology. During craniotomy for brain tumor resection maintenance of hemodynamic
stability and intracranial homoeostasis is of paramount importance. Disordered hemodynamics
or adverse stress may activate the immune inflammation or neuroendocrine responses and lead
to a surge of inflammatory mediators and stress hormones, which are implicated in secondary
brain insults.
Adverse physiological responses caused by intraoperative disordered hemodynamics or
surgery-related damage, may lead to some secondary brain injury (such as cerebral edema or
cerebral hemorrhage), aggravating damage to brain tissue and affecting the recovery from
anesthesia, cognition and prognosis in patients.
Prevention of secondary brain injury is a key-endpoint to improve clinical outcomes in glioma
patients undergoing craniotomy.
Alpha2-adrenoceptor agonists have been widely used for sedation, analgesia and
anti-sympathetic actions for many years, but the definite evidence of their potential use as
neuroprotectants has so far been confined to animal studies, yet the findings are
inconsistent.
Dexmedetomidine (DEX) has been demonstrated to be a new type a2 adrenergic receptor (a2-AR)
agonist, which can selectively bind with the a1 and a2 adrenergic receptor, and playing a
dual role by restraining the activity of sympathetic nervous and stimulating the vagus nerve.
Dexmedetomidine (DEX) also plays an important role in in inhibiting inflammatory and
neuroendocrine responses. Animal experiments showed that the right must have a
dexmedetomidine neuro-protective effect. However, the brain-protective effect of
dexmedetomidine in anesthesia of craniotomy resection of glioma has not been reported.
Thus, the aim of this study was to explore the effect of dexmedetomidine on perioperative
brain protection, as well as cerebral oxygenation and metabolic status aiming to provide a
basis for clinical rational drug use in patients undergoing craniotomy resection of glioma.