Comparison of the Effect of Dexmedetomidine and Propofol on Duration of Starting Tremor after Drug discontinuation in Parkinson's Patients under Deep Brain stimulation

Abstract

The purpose of this study was to compare the effects of Dexmedetomidine and Propofol on the duration of starting tremor after drug discontinuation in patients with Parkinson's disease under deep brain stimulation. In order to reach the research goals, 28 individuals with Parkinson's disease under deep brain stimulation were randomly assigned into two groups including Dexmedetomidine and Propofol that referring to Shahdai Tajrish Hospital in 2016. In the implementation phase. The following drugs were used: Dexmedetomidine (Precedex) with dose of 0.2-0.4 μ/kg/h and Propofol with doses of 20-30 mg bolus, and then 10-20 μ/kg/min infusion, with a control and preservation of BIS between 65 and 85, and also, RAMSY Sedation Score equal to 3. Locus of pin and the head scalp were anaesthetized with lidocaine drug. The total dose of local anaesthetic drugs was recorded at the end of the procedure. The interval time between drug discontinuation and start of tremor, and also, the time of emergence, was recorded as the time between relaxation and when the patient is able to cooperate for a neurological examination. All of the events during the operation and complications and complains of pain and restlessness were recorded. Moreover, the following cases were investigated Post-operative pain, vital signs, and hemodynamic changes, respiratory and alert status of patients for 2 hours in PACU. Patients' pain was measured using VAS (0: painless, 10: maximum pain) at intervals of 30 minutes. Independent t-test and Mann-Whitney test were used for data analysis. Findings showed that there was a significant difference between time to tremor and time to cooperation variables in the two groups. Mean comparison showed that the mean time to tremor and time to cooperation in the Propofol group was higher than the Dexmedetomidine (DEX) group. Other findings showed that there was no significant difference between BIS in the two groups. The results also showed that there was a significant difference between VAS and surgeon satisfaction variables in the two groups. Mean VAS in Propofol group was significantly higher than DEX group. Mean of surgeon satisfaction in the DEX group was significantly higher than Propofol group. In general, it can be said that patients with Parkinson's disease, Dexmedetomidine is superior drug to Propofol to deep brain stimulation.