Dexmedetomidine is an alpha-2 agonist commonly used during neurosurgery due to its unique properties as a sedative and anxiolytic with minimal respiratory depression. Neurosurgical patients frequently come to the operating room on anticonvulsant therapy with a history of seizures. The investigators clinical experience suggests that these patients are resistant to the sedative effects of dexmedetomidine. This effect may represent a pharmacokinetic interaction between the anticonvulsant medications and dexmedetomidine or the higher dexmedetomidine dose requirement could result from abnormal pharmacodynamics due to the underlying seizure disorder. The investigators study aims to investigate the pharmacokinetic and pharmacodynamic differences of dexmedetomidine between patients receiving and not receiving enzyme-inducing anticonvulsant therapy and to identify a potential mechanism for these differences.
Study Type
INTERVENTIONAL
Allocation
NA
Masking
NONE
Enrollment
16
Dexmedetomidine will be administered to 2 groups: (1) Seizure disordered patients on anticonvulsants and (2) Healthy volunteers (Control group)
University of California San Francisco
San Francisco, California, United States
Serum level of dexmedetomidine
Serum levels of dexmedetomidine will be taken at specific intervals during and after a step-wise computer controlled infusion of dexmedetomidine.
Time frame: 0-8 hour period
Patient State Index (PSI) and Entropy
PSI and/or state entropy will be recorded at specific intervals during and after a step-wise computer controlled infusion of dexmedetomidine.
Time frame: 0-8h
Visual Analog Scale score
VAS scores will be recorded at specific intervals during and after a step-wise computer controlled infusion of dexmedetomidine.
Time frame: 0-8h
Ramsay Sedation Score
Ramsay sedation scores will be recorded at specific intervals during and after a step-wise computer controlled infusion of dexmedetomidine.
Time frame: 0-8h
Observer's Assessment of Alertness/Sedation Score (OAA/S)
OAA/S scores will be recorded at specific intervals during and after a step-wise computer controlled infusion of dexmedetomidine.
Time frame: 0-8h
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