Comparison of dexmedetomidine and droperidol-fentanyl for asleep-awake-asleep techniques in awake craniotomy anesthesia: a randomized controlled study.
7 affiliations
- 1Department of Anesthesiology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
- 2Department of Anesthesiology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, China.
- 3Department of Anesthesiology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China.
- 4Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250014, China.
- 5Department of Anesthesiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250014, China.
- 6Department of Anesthesiology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China. [email protected].
- 7Department of Anesthesiology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, China. [email protected].
Abstract
Background
In this study, we aimed to compare dexmedetomidine with droperidol-fentanyl during the intraoperative awakening phase of awake craniotomy (AC), focusing on wake-up time.Methods
We conducted a single-center randomized controlled trial in China from January 2018 to December 2018. Patients aged 36-60 years, with American Society of Anesthesiologists physical status I-II, scheduled for brain glioma resection, were screened for eligibility; 61 were randomized, and 60 were included in the final analysis. The patients were randomized to either the dexmedetomidine group (intravenous loading dose of dexmedetomidine 0.5 µg·kg- 1 after discontinuation of propofol and remifentanil, followed by a maintenance infusion of dexmedetomidine 0.3-0.5 µg·kg- 1·h- 1) or the droperidol-fentanyl group (intravenous loading doses of fentanyl 2 µg·kg- 1 and droperidol 5 mg after discontinuation of propofol and remifentanil, followed by continuous maintenance infusions of fentanyl 2 µg·kg- 1·h- 1 and droperidol 0.1 mg·kg- 1·h- 1). A wake-up assessment was performed during maintenance of the assigned study regimen. The primary outcome measure was wake-up time. Secondary outcomes included the Observer's Assessment of Alertness/Sedation (OAA/S) scale, Numerical Rating Scale (NRS), eloquent brain area mapping status, vital signs, and adverse events.Results
Baseline characteristics were comparable between the groups. Compared with the droperidol-fentanyl group, the dexmedetomidine group had lower mean arterial pressure at T4-T7, lower heart rate at T1-T4 and T7, and a shorter wake-up time, with a between-group difference of 3.5 min (95% CI, 1.95 to 5.05; P < 0.001). No statistically significant differences were detected in OAA/S scores at wake-up (T2), NRS scores, eloquent area mapping status, or adverse events between the groups.Conclusion
No statistically significant differences were detected in OAA/S scores at wake-up or intraoperative brain mapping performance between the two groups. The dexmedetomidine regimen was associated with a shorter measured wake-up time.Trial registration
The Chinese Clinical Trial Registry (ChiCTR1800014329) was retrospectively registered on 6 January 2018.
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BibTeX
@article{yang2026comparison,
title = {{Comparison of dexmedetomidine and droperidol-fentanyl for asleep-awake-asleep techniques in awake craniotomy anesthesia: a randomized controlled study.}},
author = {Xiaomei Yang and Dongdong Qu and Yiyan Ren and Yaqiu Guo and Jianpeng Wang and Jianbo Wu and Jianchun Fei and Zhigang Wang and Dejie Liu},
journal = {BMC anesthesiology},
year = {2026},
month = jul,
doi = {10.1186/s12871-026-04117-y},
url = {https://europepmc.org/article/MED/42897460},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparison of dexmedetomidine and droperidol-fentanyl for asleep-awake-asleep techniques in awake craniotomy anesthesia: a randomized controlled study.
AU - Xiaomei Yang
AU - Dongdong Qu
AU - Yiyan Ren
AU - Yaqiu Guo
AU - Jianpeng Wang
AU - Jianbo Wu
AU - Jianchun Fei
AU - Zhigang Wang
AU - Dejie Liu
PY - 2026
DA - 2026/07/01
JO - BMC anesthesiology
DO - 10.1186/s12871-026-04117-y
UR - https://europepmc.org/article/MED/42897460
AB - Background In this study, we aimed to compare dexmedetomidine with droperidol-fentanyl during the intraoperative awakening phase of awake craniotomy (AC), focusing on wake-up time.Methods We conducted a single-center randomized controlled trial in China from January 2018 to December 2018. Patients aged 36-60 years, with American Society of Anesthesiologists physical status I-II, scheduled for brain glioma resection, were screened for eligibility; 61 were randomized, and 60 were included in the final analysis. The patients were randomized to either the dexmedetomidine group (intravenous loading dose of dexmedetomidine 0.5 µg·kg- 1 after discontinuation of propofol and remifentanil, followed by a maintenance infusion of dexmedetomidine 0.3-0.5 µg·kg- 1·h- 1) or the droperidol-fentanyl group (intravenous loading doses of fentanyl 2 µg·kg- 1 and droperidol 5 mg after discontinuation of propofol and remifentanil, followed by continuous maintenance infusions of fentanyl 2 µg·kg- 1·h- 1 and droperidol 0.1 mg·kg- 1·h- 1). A wake-up assessment was performed during maintenance of the assigned study regimen. The primary outcome measure was wake-up time. Secondary outcomes included the Observer's Assessment of Alertness/Sedation (OAA/S) scale, Numerical Rating Scale (NRS), eloquent brain area mapping status, vital signs, and adverse events.Results Baseline characteristics were comparable between the groups. Compared with the droperidol-fentanyl group, the dexmedetomidine group had lower mean arterial pressure at T4-T7, lower heart rate at T1-T4 and T7, and a shorter wake-up time, with a between-group difference of 3.5 min (95% CI, 1.95 to 5.05; P < 0.001). No statistically significant differences were detected in OAA/S scores at wake-up (T2), NRS scores, eloquent area mapping status, or adverse events between the groups.Conclusion No statistically significant differences were detected in OAA/S scores at wake-up or intraoperative brain mapping performance between the two groups. The dexmedetomidine regimen was associated with a shorter measured wake-up time.Trial registration The Chinese Clinical Trial Registry (ChiCTR1800014329) was retrospectively registered on 6 January 2018.
SN - 1471-2253
ER -