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Table of Contents    
LETTERS TO EDITOR
Year : 2019  |  Volume : 67  |  Issue : 5  |  Page : 1363

Neuroprotective Role of Dexmedetomidine in Epilepsy Surgery


1 Department of Neuroanesthesiologist and Intensivist, University Hospital Fundacion, Santafe de Bogota, Colombia
2 Department of Anesthesiology, University Hospital Fundacion, Santafe de Bogota, Colombia

Date of Web Publication19-Nov-2019

Correspondence Address:
Dr. Claudia Nino
Cra. 9 No 116 – 20, 7th Floor, Bogota - 1100110
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.271254

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How to cite this article:
Nino C, Mercado JD, Cabrera N, Quintero CI. Neuroprotective Role of Dexmedetomidine in Epilepsy Surgery. Neurol India 2019;67:1363

How to cite this URL:
Nino C, Mercado JD, Cabrera N, Quintero CI. Neuroprotective Role of Dexmedetomidine in Epilepsy Surgery. Neurol India [serial online] 2019 [cited 2019 Dec 9];67:1363. Available from: http://www.neurologyindia.com/text.asp?2019/67/5/1363/271254




Sir,

We have reviewed the clinical trial entitled Neuroprotective role of dexmedetomidine in epilepsy surgery: A preliminary study By Ashish B, published in Neurology India journal (2019; 67:163-168) with interest.

Serum biomarkers can be used to evaluate the central nervous immune response before injury. Changes in the levels of these biomarkers have been shown related to brain trauma in both adults and children, cerebral infarct, and in subarachnoid hemorrhage. They have been related to adverse outcomes, infarct size, and mortality as well.[1],[2] The availability of these markers in neurosurgery allows the detection neuronal compromise and astrocyte activation secondary to surgical trauma and manipulation as well as the evaluation of the patient response to the drugs used during general anesthesia.[3],[4]

First, we want to congratulate the authors for presenting the interesting properties of dexmedetomidine as a cerebral protector. However, we want to make some observations regarding the statistical analyses and conclusions of the study.

Although the two groups analyzed had similar demographic characteristics, the same diagnoses of long-standing temporal lobe epilepsy (TLE), and met the same criteria for inclusion and exclusion, it is worth mentioning that the baseline S100B level in the control group was higher than in the demedetomidine groun with a statistically significant difference (p = 0.006). In addition, there was a proportional increase of S100B levels in both groups at the 24-hour post-surgery mark (14.8% in the control and 15.3% in the interventional group) with the standard deviation being the greater in the control group.

Furthermore, a decrease of the S100B biomarker at the end of the surgery and 48 hours post-operation is evidenced in the control group results. This reflects a better dynamic of this biomarker in patients without intervention. Thus, it is difficult to consider a relationship between the levels of S100B and the potentially neuroprotective effect of the dexmedetomidine during TLE surgery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Foerch C, Otto B, Singer OC, Neumann-Haefelin T, Yan B, Berkefeld J, et al. Serum S100B predicts a malignant course of infarction in patients with acute middle cerebral artery occlusion. Stroke 2004;35:2160-4.  Back to cited text no. 1
    
2.
Foerch C, Singer OC, Neumann-Haefelin T, du Mesnil de Rochemont R, Steinmetz H, Sitzer M. Evaluation of serum S100B as a surrogate marker for long-term outcome and infarct volume in acute middle cerebral artery infarction. Arch Neurol 2005;62:1130-4.  Back to cited text no. 2
    
3.
Monbailliu T, Goossens J, Hachimi-Idrissi S. Blood protein biomarkers as diagnostic tool for ischemic stroke: A systematic review. Biomark Med 2017;1:503-12.  Back to cited text no. 3
    
4.
Oris C, Pereira B, Durif J, Simon-Pimmel J, Castellani C, Manzano S, et al. The biomarker S100B and mild traumatic brain injury: A meta-analysis. Pediatrics 2018;14. doi: 10.1542/peds. 2018-0037.  Back to cited text no. 4
    




 

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