Dexmedetomidine produces more sleep-like brain activity compared with propofol in human participants
Bryan M Krause1, Emily R Dappen2, Rashmi N Mueller3
1Department of Anesthesiology, University of Wisconsin, Madison, WI, USA.
Background:
Dexmedetomidine is a selective α2-adrenergic agonist used as an anaesthesia adjunct to produce a state of sleep-like sedation. How brain activity compares quantitatively during dexmedetomidine anaesthesia with that during natural sleep remains unclear. We have shown that the general anaesthetic propofol is associated with changes in connectivity and cortical network structure similar to sleep. Here, we compare quantitatively the effects of dexmedetomidine, propofol, and sleep on brain activity.
Methods:
Intracranial encephalography recordings were obtained in 34 patients with epilepsy being evaluated for seizure resection surgery. Band power, functional connectivity, and network entropy were measured during task-free periods just before surgery, during anaesthesia with either dexmedetomidine or propofol, and during overnight sleep. Anaesthesia stage (wake, sedated, unresponsive) was determined using the Observer's Assessment of Arousal/Sedation. Sleep was staged using standard polysomnography.
Results:
Significant differences in delta power were observed during dexmedetomidine and propofol anaesthesia and during sleep. However, the magnitude of changes in delta power was smaller and regionally heterogeneous for propofol compared with dexmedetomidine and sleep, whereas changes in network entropy were larger for propofol compared with dexmedetomidine and sleep. Quantitative comparisons between changes in delta power and network entropy suggest that unresponsiveness under dexmedetomidine anaesthesia produces a similar brain state to that observed during N2 sleep.
Conclusions:
Although delta power, functional connectivity, and network entropy all showed changes during propofol, dexmedetomidine, and sleep, the magnitudes of these changes suggest that the effects of dexmedetomidine are more similar than those of propofol to sleep, specifically to N2 sleep.
Related Concept Videos
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Parenteral Anesthetics: Overview
Sedatives and Hypnotics Drugs: Benzodiazepines
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Management of Insomnia
Sedatives and Hypnotics Drugs: Barbiturates


