Discover how the latest research reveals the impact of ketamine and dexmedetomidine on intraoperative cranial nerve monitoring during delicate posterior fossa craniotomies, potentially revolutionizing anesthesia protocols in critical neurosurgery.
– by Marv
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Effect of Ketamine and Dexmedetomidine as Adjuvant to Total Intravenous Anesthesia on Intraoperative Cranial Nerve Monitoring in the Patients Undergoing Posterior Fossa Craniotomies-A Randomized Quadruple Blind Placebo-Controlled Study.
Pathak et al., Asian J Neurosurg 2023
DOI: 10.1055/s-0043-1772762
Objectives Oh, what a time to be alive! We’re mixing cocktails of drugs to see if we can keep those brain signals bopping during brain surgery without knocking them out completely. The goal? To see if adding a little sprinkle of ketamine or dexmedetomidine to our propofol-fentanyl happy hour can keep the corticobulbar motor evoked potentials (CoMEPs) from taking a nosedive.
Materials and Methods We played eeny, meeny, miny, moe with 42 patients and split them into three groups (because, why not?). Group S got the saline placebo (party poopers), Group D got the dexmedetomidine (the chill cousin), and Group K got ketamine (the life of the party). Everyone got a steady stream of propofol and fentanyl, because we’re generous like that. Then we zapped their brains at intervals to see if the muscles twitched.
Results Drumroll, please… Turns out, the ketamine crew kept the party going longer at T4 and T5, with their muscle responses not dropping as much as the others. The dexmedetomidine group, well, they tried, but latency got a bit sluggish. And the saline group? Let’s just say they weren’t the life of the party.
Conclusion In the epic battle of anesthesia additives, ketamine might just be your MVP for long surgeries. It keeps those CoMEPs coming better than a propofol-fentanyl mixtape on repeat. Who knew a horse tranquilizer could be such a game-changer in neurosurgery?