ArticleAsian journal of neurosurgery2026
Effect of Dexmedetomidine on Electrocorticography During Epilepsy Surgery under Isoflurane or Propofol Anesthesia: A Prospective, Randomized Trial.
Article in Asian journal of neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Avoiding or minimizing the interference of anesthetic agents with electrocorticography (ECoG) signals during ECoG-guided epilepsy surgery is vital to the successful resection of the epileptogenic area. Most agents in routine use have widely variable effects like suppression, enhancement, or no impact on the ECoG signals. Dexmedetomidine is reported to have no influence, or minimal depressant effect, on the signals, but studies evaluating its effect on intraoperative ECoG are limited. This study evaluates the effect of dexmedetomidine on ECoG signals during ECoG-guided epilepsy surgeries conducted under either isoflurane-based or propofol-based anesthesia regimens. It also assesses the safety of dexmedetomidine use in these combination forms by determining its impact on hemodynamic parameters, recovery from anesthesia, and incidence of intraoperative awareness. Materials and Methods: Thirty epilepsy patients, randomized into Group-I (dexmedetomidine-isoflurane, Results: Dexmedetomidine did not cause ECoG suppression when administered with either propofol or isoflurane anesthesia. However, it caused a significant increase in the ECoG score in Group-I (baseline: 1.8 ± 0.7; post-dexmedetomidine: 2.1 ± 0.9; Conclusion: Dexmedetomidine, when used with propofol anesthesia, had no effect on the intraoperative ECoG signals, hemodynamic parameters, and anesthesia recovery time. Use of dexmedetomidine with isoflurane anesthesia also did not cause ECoG suppression, but significantly augmented the ECoG scores, while normal hemodynamic and recovery status were maintained. There was no incident of intraoperative awareness in either group. As per this study, the dexmedetomidine-propofol anesthetic regimen appears to be suitable for use in ECoG-guided epilepsy surgeries. However, the ECoG-enhancing effect observed with dexmedetomidine when used with isoflurane necessitates further research for validation and to understand its clinical implications.
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