Chulalongkorn Medical Journal


Background : A number of the anesthesia regimens are used incraniotomy. Rapid emergence is one of the important goals inNeuroanesthesia. In this study, we compared desfluraneinhalation and propofol TCI regimen in patients undergoingcraniotomy for temporal lobectomy regarding recovery profilesincluding time of recovery, cognitive function, postoperative pain,post-operative nausea and vomiting (PONV). In addition, wecompared the costs between the two regimens.Objective : To study effects of desflurane inhalation regimen and propofolTCI in patients undergoing elective craniotomy for temporallobectomy. Recovery profiles, post-operative complications andtreatments and overall costs between two group are comparedDesign : Randomized double-blind prospective studySetting : Neurosurgery and Neuroanesthesia unit at King ChulalongkornMemorial Hospital.Materials and Method : Forty-two patients were randomly assigned into group D withdesflurane inhalation and group P with propofol TCI. Anestheticdepth was controlled by bispectral index (BIS). Time toawakening, cognitive function using Mini-Mental Status Exam(MMSE-Thai version), pain score and PONV were documented.Clinical symptoms and recovery profiles of all patients werefollowed up until 24 hours postoperatively.Results : Time from discontinuing anesthesia to eyes opening was fasterin group D than group P (5.20 2.91 vs. 8.90 4.64 min).However, times to extubation and orientation were similar.There were no statistically significant differences in Post-Anesthesia Recovery Scores (PARS), discharge times or MMSEscores between the two groups. More Significant number ofpatients suffered from PONV in group D than group P (45% vs.4%). Pain scores and shivering needed to be treated; 24-hourMMSE scores were not different. However, overall costs weresignificantly higher in group P than group D (2924.88 vs.1474.34Thai Baht).Conclusion : Patients in both groups showed similar emergence andrecovery profiles. However, the costs of propofol TCI regimenwere significantly higher than that of desflurane inhalation group.


Faculty of Medicine, Chulalongkorn University

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