Explore the groundbreaking study on the long-term effects of postoperative prolonged sedation with Dexmedetomidine on patients with acute ischemic stroke, shedding light on ethical considerations in neurosurgical practices.
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Effect of Postoperative Prolonged sedation with Dexmedetomidine after successful reperfusion with Endovascular Thrombectomy on long-term prognosis in patients with acute ischemic stroke (PPDET): study protocol for a randomized controlled trial.
Yang et al., Trials 2024
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https://doi.org/10.1186/s13063-024-08015-x
This study explores the potential benefits of prolonged sedation with dexmedetomidine (DEX) following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) due to large vessel occlusion. Recognizing that hypertension and blood pressure variability post-EVT are linked to increased risks of symptomatic intracerebral hemorrhage and mortality, and that patients may experience ischemia-reperfusion injury within 24 hours post-reperfusion, this trial investigates whether DEX can improve outcomes by stabilizing hemodynamics and mitigating ischemia-reperfusion injury through its anti-inflammatory and antioxidative effects.
The study is a single-center, open-label, prospective, randomized controlled trial involving 368 patients, approved by the ethics committee. Participants, post-successful reperfusion, are randomly assigned to receive either 0.1~1.0 μg/kg/h DEX or an equivalent dose of saline for 24 hours. The primary outcome is the functional outcome at 90 days, assessed by the modified Rankin Scale. Secondary outcomes include changes in stroke severity, ischemic penumbra/infarct volume, length of ICU/hospital stay, and 90-day adverse events and mortality rates.
This trial, registered at ClinicalTrials.gov (NCT04916197), aims to confirm the hypothesis that DEX sedation post-EVT can enhance long-term prognosis in AIS patients, potentially reducing socio-economic burdens.