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Comparison of intraoperative brain condition, hemodynamics and postoperative recovery between desflurane and sevoflurane in patients undergoing supratentorial craniotomy.

Dube SK, Pandia MP, Chaturvedi A, Bithal P, Dash HH - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: There was no difference in ICP [Group D; 9.1 ± 4.3 mmHg vs.Group S; 10.9 ± 4.2 mmHg; P = 0.14] and brain condition between the two groups.Both groups had similar post-operative complications, hospital and ICU stay and GOS.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Post operative recovery has been reported to be faster with desflurane than sevoflurane anesthesia in previous studies. The use of desflurane is often criticized in neurosurgery due to the concerns of cerebral vasodilation and increase in ICP and studies comparing desflurane and sevoflurane in neurosurgey are scarce. So we compared the intraoperative brain condition, hemodynamics and postoperative recovery in patients undergoing elective supratentorial craniotomy receiving either desflurane or sevoflurane.

Materials and methods: Fifty three patients between 18-60yr undergoing elective supratentorial craniotomy receiving N2O and oxygen (60%:40%) and 0.8-1.2 MAC of either desflurane or sevoflurane were randomized to group S (Sevoflurane) or group D (Desflurane). Subdural intra cranial pressure (ICP) was measured and brain condition was assessed.. Emergence time, tracheal extubation time and recovery time were recorded. Cognitive behavior was evaluated with Short Orientation Memory Concentration Test (SOMCT) and neurological outcome (at the time of discharge) was assessed using Glasgow Outcome Score (GOS) between the two groups.

Results: The emergence time [Group D 7.4 ± 2.7 minutes vs. Group S 7.8 ± 3.7 minutes; P = 0.65], extubation time [Group D 11.8 ± 2.8 minutes vs. Group S 12.9 ± 4.9 minutes; P = 0.28] and recovery time [Group D 16.4 ± 2.6 minutes vs. Group S 17.1 ± 4.8 minutes; P = 0.50] were comparable between the two groups. There was no difference in ICP [Group D; 9.1 ± 4.3 mmHg vs. Group S; 10.9 ± 4.2 mmHg; P = 0.14] and brain condition between the two groups. Both groups had similar post-operative complications, hospital and ICU stay and GOS.

Conclusion: In patients undergoing elective supratentorial craniotomy both sevoflurane and desflurane had similar intra-operative brain condition, hemodynamics and post operative recovery profile.

No MeSH data available.


Related in: MedlinePlus

Consort flow diagram of the study
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Figure 1: Consort flow diagram of the study

Mentions: In this study, a total of 107 patients were assessed for eligibility, of which 54 patients were excluded. Of the remaining 53 eligible patients, 3 were excluded (2 in desflurane and 1 in the sevoflurane group) due to need for postoperative ventilation or reintubation in the postoperative period [Figure 1]. A total of 50 patients (Group D 24 patients and Group S 26 patients) were included in the final analysis.


Comparison of intraoperative brain condition, hemodynamics and postoperative recovery between desflurane and sevoflurane in patients undergoing supratentorial craniotomy.

Dube SK, Pandia MP, Chaturvedi A, Bithal P, Dash HH - Saudi J Anaesth (2015 Apr-Jun)

Consort flow diagram of the study
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374222&req=5

Figure 1: Consort flow diagram of the study
Mentions: In this study, a total of 107 patients were assessed for eligibility, of which 54 patients were excluded. Of the remaining 53 eligible patients, 3 were excluded (2 in desflurane and 1 in the sevoflurane group) due to need for postoperative ventilation or reintubation in the postoperative period [Figure 1]. A total of 50 patients (Group D 24 patients and Group S 26 patients) were included in the final analysis.

Bottom Line: There was no difference in ICP [Group D; 9.1 ± 4.3 mmHg vs.Group S; 10.9 ± 4.2 mmHg; P = 0.14] and brain condition between the two groups.Both groups had similar post-operative complications, hospital and ICU stay and GOS.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Post operative recovery has been reported to be faster with desflurane than sevoflurane anesthesia in previous studies. The use of desflurane is often criticized in neurosurgery due to the concerns of cerebral vasodilation and increase in ICP and studies comparing desflurane and sevoflurane in neurosurgey are scarce. So we compared the intraoperative brain condition, hemodynamics and postoperative recovery in patients undergoing elective supratentorial craniotomy receiving either desflurane or sevoflurane.

Materials and methods: Fifty three patients between 18-60yr undergoing elective supratentorial craniotomy receiving N2O and oxygen (60%:40%) and 0.8-1.2 MAC of either desflurane or sevoflurane were randomized to group S (Sevoflurane) or group D (Desflurane). Subdural intra cranial pressure (ICP) was measured and brain condition was assessed.. Emergence time, tracheal extubation time and recovery time were recorded. Cognitive behavior was evaluated with Short Orientation Memory Concentration Test (SOMCT) and neurological outcome (at the time of discharge) was assessed using Glasgow Outcome Score (GOS) between the two groups.

Results: The emergence time [Group D 7.4 ± 2.7 minutes vs. Group S 7.8 ± 3.7 minutes; P = 0.65], extubation time [Group D 11.8 ± 2.8 minutes vs. Group S 12.9 ± 4.9 minutes; P = 0.28] and recovery time [Group D 16.4 ± 2.6 minutes vs. Group S 17.1 ± 4.8 minutes; P = 0.50] were comparable between the two groups. There was no difference in ICP [Group D; 9.1 ± 4.3 mmHg vs. Group S; 10.9 ± 4.2 mmHg; P = 0.14] and brain condition between the two groups. Both groups had similar post-operative complications, hospital and ICU stay and GOS.

Conclusion: In patients undergoing elective supratentorial craniotomy both sevoflurane and desflurane had similar intra-operative brain condition, hemodynamics and post operative recovery profile.

No MeSH data available.


Related in: MedlinePlus