CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2017; 04(04): S105
DOI: 10.1055/s-0038-1646238
Abstracts
Thieme Medical and Scientific Publishers Private Ltd.

Comparison of effects of propofol infusion on the middle cerebral velocity between normal and tumor side in patients with intracranial space occupying lesions

S. Manikandan
1   Division of Neuroanesthesia and Neurocritical Care, SCTIMST, Trivandrum, Kerala, India
,
S. Narayan
1   Division of Neuroanesthesia and Neurocritical Care, SCTIMST, Trivandrum, Kerala, India
› Author Affiliations
Further Information

Publication History

Publication Date:
09 May 2018 (online)

Introduction: Propofol is a common anesthetic agent used for induction of anesthesia as well as maintenance as well as total intravenous anesthesia in neurosurgical procedures. Propofol in common with intravenous agents reduces the cerebral blood flow and metabolism in normal brain. However, in areas with intracranial intraaxial tumors the cerebral vascular effects of propofol has not been well studied. The aim of the present study is to prove the hypothesis that cerebrovascular effects of propofol will be similar between tumor and non tumor hemispheres. Methods: The study was approved by institutional ethic committee. Adult patients with ASA grade 1 and 2 presenting with unilateral large intraaxial tumors (>5 cm) (Group 1) and spinal cord pathology (Group 2) were included. After standard monitoring and preoxygenation, anesthesia was induced with propofol infusion 10 mg/kg/hr. Bispectral index was targeted to 60. Transcranial doppler was used to assess the mean flow velocity in the middle cerebral artery at baseline and at BIS 60 in both hemispheres. Hemodynamic and CO2 levels were maintained constant. Statistical analysis consist test for mean and p<0.05 was considered significant. Results: Twenty four adults were included in the study. There was no change in the hemodynamic paramaters (SpO2 and EtCO2) values between the two readings. The mean flow velocity at baseline in the control group was higher compared to the Group 1. There was a non-significant reduction in flow velocity in both the groups following propofol infusion. When compared to tumor hemisphere the non-tumor hemisphere had higher FV at baseline. However following the propofol infusion, the FV decreased significantly in both hemispheres, but no difference between hemispheres. Conclusion: Intravenous administration of propofol caused significant reduction in FV in both tumor and control groups. However the FV decreased more in non-tumor hemisphere compared to tumor hemisphere implying the maintenance of autoregulation or flow metabolism coupling. The mechanism needs to be elucidated.