PDF icon PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(04): 826-830
DOI: 10.1055/s-0043-1775588
Clinical Investigation

Propofol versus Desflurane in Moyamoya Disease Patients—A Pilot Study

Ronak R. Ankolekar
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2   Senior Registrar Department of Critical Care Medicine, Narayana Health, Bangalore, Karnataka, India
,
Kirandeep Kaur 
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Kiran Jangra 
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ashish Aggarwal
3   Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Nidhi B. Panda
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Hemant Bhagat
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Amiya K. Barik 
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Institutsangaben
Funding Support was provided solely from institutional and/or departmental sources.
› Weitere Informationen
Auch verfügbar aufeRef
  Lizenzen und Reprints
Preview

Abstract

Objectives The choice of inhalational or intravenous anesthetic agents is debatable in neurosurgical patients. Desflurane, a cerebral vasodilator, may be advantageous in ischemic cerebral pathologies. Hence, we planned to compare desflurane and propofol in patients with moyamoya disease (MMD) with the objective of comparing neurological outcomes.

Materials and Methods This prospective pilot trial was initiated after institutional ethics committee approval. Patients with MMD undergoing revascularization surgery were randomized into two groups receiving either desflurane or propofol intraoperatively. Neurological outcomes were assessed using a modified Rankin score (mRS) at discharge and an extended Glasgow outcome score (GOS-E) at 1 month. Intraoperative parameters, including hemodynamic parameters, end-tidal carbon dioxide, entropy, intraoperative brain relaxation scores (BRS), and rescue measures for brain relaxation, were compared.

Statistical Analysis The normality of quantitative data was checked using Kolmogorov–Smirnov tests of normality. Normally distributed data were compared using unpaired t-tests, skewed data using Mann–Whitney U tests, and categorical variables using chi-squared tests.

Results A total of 17 patients were randomized, 10 in the desflurane and 7 in the propofol group. mRS (1.3 ± 0.6 and 1.14 ± 0.4, p = 0.450) and GOS-E (6.7 ± 0.6 and 6.85 ± 0.5, p = 0.45) were comparable between desflurane and propofol groups, respectively. BRS was significantly higher in the desflurane group (3.6 ± 0.5) compared to the propofol group (2.1 ± 0.3, p = 0.001), with a significant number of patients requiring rescue measures in the desflurane group (70%, p < 0.001). Other outcome parameters were comparable (p > 0.05).

Conclusion We conclude that postoperative neurological outcomes were comparable with using either an anesthetic agent, desflurane, or propofol in MMD patients undergoing revascularization surgery. Maintenance of anesthesia with propofol had significantly superior surgical field conditions.

Keywords

anesthesia - desflurane - moyamoya disease - propofol

Ethical Approval Statement

The original work has been done after approval from Institutional Ethics Committee (No: NK/5730/MD/456) and Helsinki guidelines were followed.


Authors' Contributions

R.R.A., K.J., N.B.P., and H.B. conceptualized and designed the study. K.J., K.K., and A.A. were involved in acquisition, analysis, and interpretation of data. K.J., K.K., A.B., and R.R.A. helped in manuscript preparation. K.J., K.K., A.A., A.B., N.B.P., and H.B. helped in critical revision of the manuscript for important intellectual content. All authors reviewed the results and approved the final version of the manuscript.




Publikationsverlauf

Artikel online veröffentlicht:
07. November 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India