COMPARATIVE STUDY OF THIOPENTONE-ISOFLURANE VERSUS PROPOFOL IN NEUROANESTHESIA FOR INTRACRANIAL SURGERY

Abstract

The choice of anesthetic technique for neurosurgical procedures has the priority to conserve neuronal function by avoidance of complication, such as hypoxia, hypercarbia and cardiovascular instability.

Thereafter, the chosen anesthetic technique should not (or minimally) interfere with cerebral autoregulation and C02 responsiveness, while brain relaxation is encouraged by decreasing the cerebral metabolic rate for oxygen (CMR02) and cerebral blood flow (CBF), and cardiovascular parameters are maintained within the normal range.

Propofol seemed to be an attractive intravenous anesthetic and may be a possible alternative to the widely used thiopentone­ isoflurane, which avoids the use of the cerebral vasodilatation effect ofisoflurane (Archer et al, 1987).

Our aim in this study was to compare the effects of using thiopentone-isoflurane, versus propofol on hemodynamics, cerebral perfusion pressure and cerebral metabolism during neurosurgical procedures.

Sixty consenting patients ASA class I or II were included in the study. Scheduled for elective intracranial procedure with a Glassgow Coma Score (GCS) of 15 and with no clinical signs of increased ICP, were randomly assigned to either a thiopentone­ isoflurane group (group I, N = 30) or a propofol group (group II, N = 30).

All patients were premedicated prior to the operation with proper dose ofmidazolam, given intramuscularly.