Effects of mild sedation on neurologic function in patients with supratentorial mass lesion and the associated factors in head magnetic resonance imaging

doi:10.3969/j.issn.1006-7795.2017.02.029

Abstract

Abstract: Objective Sedation may induce or exacerbate neurologic function in some patients with supratentorial mass lesion. This trial aimed to investigate the risk factor of sedative associated neurologic deficits in that population through analyzing head magnetic resonance imaging (MRI). Methods The study was a prospective, randomized, single-blind, controlled trial. Patients were randomly assigned to one of the four study groups, including 'Propofol group', 'Midazolam group', 'Fentanyl group' or 'Dexmedetomidine group'. In each group, patients were titrated to Observer's Assessment of Alertness and Sedation (OAA/S) score 4 with a ladder-like administration of the assigned drug to target this same sedation level. National Institutes of Health Stroke Scale (NIHSS) was applied to evaluate before and after the sedation. Patients' magnetic resonance imaging (MRI) findings were collected after the evaluation. Results This study showed that mild sedation unmasked or exacerbated neurologic deficits in patients with supratentorial brain tumors. Patients with brain tumors in the primary motor area(P=0.000),primary sensory area(P=0.004), basil ganglion(P=0.031), with brain midline shift(P=0.000), brain ventricular compression or expansion(P=0.000) as well as present peritumor edema(P<0.001)had a higher probability of sedative related neurologic deficits. Conclusion The neurologic function altering is more sensitive to sedation if MRI displays a primary motor area mass lesion and brain midline shift. However the potential mechanism of sedative related neurologic deficits is still in need of further investigation.

Key words: sedation, neurologic deficit, brain mass lesion, magnetic resonance imaging

CLC Number:

R445.2

Lin Nan, Zhou Jianxin, Han Ruquan. Effects of mild sedation on neurologic function in patients with supratentorial mass lesion and the associated factors in head magnetic resonance imaging[J]. Journal of Capital Medical University, 2017, 38(2): 313-319.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2017.02.029

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2017/V38/I2/313

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