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Ocena bezpieczeństwa i skuteczności dexmedetomidyny stosowanej w celu sedacji w zabiegach biopsji stereotaktycznej

100%
Duda I., Kwiek S. J., Grzybowska K., Kocur D.
Annales Academiae Medicae Silesiensis
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2014
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vol. 68
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issue 5
284-288
EN
NTRODUCTION Dexmedetomidine (DEX) is an agonist of the alfa-2 adrenergic receptor. It possesses unique sedative properties without depression of the cardiovascular or respiratory system. The aim of this work was to evaluate the efficiency and safety of using dex in stereotactic biopsy. MATERIALS AND METHODS 24 patients qualified for stereotactic biopsy were divided into 2 groups: DEX (n = 12) and KON (n = 12). In DEX, 0.5 μg/kg/h dex has been used. In KON there was no sedation used. Intraoperative changes in the systolic blood pressure (SBP) and heart rate (HR) values were compared in both groups. The sedation level was estimated on the OAA/S scale. RESULTS In DEX, the intraoperative SBP value was significantly lower than in the KON group. No hypertension incidence in DEX was observed. Dex provided patient comfort. CONCLUSION Sedation with the usage of dex increases the comfort and safety of patients during stereotactic biopsy.
PL
Wstęp Dexmedetomidyna (DEX) jest agonistą receptora adrenergicznego alfa2. Ma unikalne właściwości sedacyjne bez depresji układu krążenia i oddechowego. Celem pracy była ocena skuteczności i bezpieczeństwa użycia DEX w zabiegach biopsji stereotaktycznej. MATERIAŁ I METODY Grupę 24 pacjentów zakwalifikowanych do biopsji stereotaktycznej podzielono na grupy: badaną (DEX; n = 12) i kontrolną (KON; n = 12). W grupie badanej podawano wlew DEX 0,5 µg/kg/h, w kontrolnej nie stosowano sedacji. W obu grupach porównano śródoperacyjne zmiany wartości skurczowego ciśnienia krwi (systolic blood pressure - SBP) i częstości akcji serca (heart rate - HR). Oceniono stopień sedacji w skali OAA/S. WYNIKI W grupie DEX obserwowano śródoperacyjnie istotnie niższe wartości SBP, bez incydentów hipertensji. Stopień sedacji pacjentów był wyższy w grupie DEX. WNIOSKI Sedacja z użyciem DEX poprawia komfort i bezpieczeństwo pacjentów w czasie biopsji stereotaktycznej.
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Ocena skuteczności oraz ryzyka powikłań „bezramowej” biopsji stereotaktycznej guzów mózgu opartej na neuronawigacji i badaniu MRI

84%
Chodakowski P., Kapustka B., Marcol W., Kiwic G., Wysokiński T.
Annales Academiae Medicae Silesiensis
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2016
|
vol. 70
122-126
EN
INTRODUCTION: Stereotactic biopsy is a relatively commonly used tool for brain tumour diagnostics. A frame-based stereotactic biopsy is the standard, but the so-called 'frameless' biopsy, which is done by using a special neuronavigation system, seems to be a safe and convenient alternative. The authors have assessed the safety and effectiveness of an MRI based 'frameless' stereotactic biopsy of brain tumours. MATERIAL AND METHODS: 42 cases of patients, who underwent 'frameless' brain tumour biopsies in 2011–2013, were been retrospectively analysed. The biopsies were done by using BrainLab™ neuronavigation with VarioGuide and biopsy side-cut needles. The operation plan was based on a preoperative MRI head. In every case, at least 3 specimens various trajectories were taken. Pathological analysis was performed in the same place in every case. RESULTS: There were 85.7% cases with an exact histopathological result. 14.3% cases obtained a pathological result, but without exact diagnosis. One patient (2.4%) with astrocytoma WHO III died as a result of a perioperative intraventricular hemorrhage. Other clinically significant perioperative complications occurred in 2 cases (4.8%). The histopathological diagnostics revealed: 12 cases of GBM (28.6%), 8 cases of astrocytoma WHO III (19%), 10 cases of astrocytoma WHO II (23.8%), 1 case of metastasis (2.4%), 1 case of lymphoma (2.4%) as well as 2 other lesions (4.8%). Statistical analysis revealed no significant differences in the patients’ pre- and postoperative state. CONCLUSIONS: The 'frameless' biopsy is an effective and relatively safe way of diagnosing brain tumours. This type of biopsy takes less time to perform. It seems that it can be recommended as a convenient alternative to frame-based biopsy.
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