COMPARISON OF PROPOFOL/DEXMEDETOMIDINE FOR ASLEEP AWAKE ASLEEP TECHNIQUE FOR AWAKE CRANIOTOMIES IN TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 1
Abstract
BACKGROUND Awake craniotomy is an important technique used for brain tumour excision from eloquent cortex, epilepsy foci removal surgery, deep brain stimulation, less commonly for mycotic aneurysms, A-V malformation near cortical areas. Aims and Objectives- To access quality of brain mapping, haemodynamic stability, perioperative airway security, & observation of adverse effects in propofol, dexmedetomidine groups for awake craniotomies. Group Allocation- (Maintenance of anaesthesia in both groups was different as follows :) Group A (Propofol Group): inj. propofol 6 mg/kg/hour for 10 min, then 4 mg/kg/hour. (n=25) Group B (Dexmedetomidine group): Inj. dexmedetomidine 0.5 mg/kg/hour (n=25). MATERIALS & METHODS This randomised double-blind comparative study of premedication- Inj. glycopyrrolate 0.04 mg/kg, inj. ondansetron 0.08 mg/kg & in fentanyl 1 mcg/kg. Scalp block: scalp block was given with inj. Ropivacaine 0.5% 30 ml to block supraorbital, supratrochlear, zygomatic temporal, auriculotemporal nerves, greater auricular, lesser auricular nerves in General Hospital, NHLM medical college, Ahmedabad, Gujarat, India. Induction- Induction was done with inj. thiopentone 5 to 7 mg/kg IV. Airway security- By i-gel (second generation laryngeal mask airway) MaintenanceIn group A: inj. propofol 6 mg/kg/hour for first 10 min then 4 mg/kg/hour In group B: inj. dexmedetomidine 1 mcg/kg/hour for first 10 min then 0.5 mcg/kg/hour When neurosurgeon wanted to perform brain mapping, patient's i-gel was removed & patients were managed with low dose of propofol & dexmedetomidine in awake period, then further dose was increased in 3rd phase, that is asleep period. RESULTS NRS score of cortical mapping was comparable in both groups- In both groups haemodynamic variables were stable & comparable. In group B better airway management & less complications observed. CONCLUSION In AAA method for awake craniotomies, use of dexmedetomidine is a good alternative to propofol.
Authors and Affiliations
Manisha S. Kapdi, Rupal J. Shah, Shvangi Patel, Manhar G. Vachhani, Nidhi Patel
Keywords
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- EP ID EP553011
- DOI 10.14260/jemds/2019/4
- Views 70
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