Comparative Evaluation of Perioperative Haemodynamics and Emergence Profile Among  Isoflurane, Sevoflurane and Desflurane in Patients Undergoing Elective Supratentorial Craniotomy for Space Occupying Lesion:

Rakesh K Dubey; Jitendra S Chahar; Deepak Malviya; Virendra Kumar; Manoj Tripathi

doi:10.21276/aan.2018.3.2.2

Rakesh K Dubey Senior Resident, Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Jitendra S Chahar Senior Resident, Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Deepak Malviya Professor, Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Virendra Kumar Associate Professor, Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Manoj Tripathi Assistant Professor, Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

DOI: https://doi.org/10.21276/aan.2018.3.2.2

Keywords: Isoflurane, desflurane, sevoflurane, supratentorial craniotomy, emergence time, extubation time, emergence hypertension

Abstract

Background: Introduction of sevoflurane and desflurane had increased anaesthetic choices for maintenance of general anesthesia in neurosurgical cases after isoflurane. Aims: To compare emergence characteristics, intraoperative haemodynamic and intraoperative brain relaxation between isoflurane, sevoflurane and desflurane in patients undergoing elective supratentorial craniotomy. Settings and Design: Randomized, prospective and comparative study. Subjects and Methods: In this study, recruited patients were randomly allocated in three groups. Groups I, S, and D received Isoflurane, sevoflurane and desflurane in MAC (0.8-1.2) during maintenance of general anesthesia after endotracheal intubation till skin closure. Emergence time, extubation time, perioperative hypertension and intraoperative brain relaxation were compared between 3 groups across different time period. Statistical Analysis: Mean and standard deviation were calculated. Test of analysis between two groups was done by t-test and among three groups by analysis of variance, and then P value was calculated. Results: Significantly lesser emergence time and extubation time was found in group D compared to group I and group S (7.532.11 vs 15.101.74 vs 10.501.19 and 10.871.961 vs 18.201.92 vs 14.002.068). Incidence of emergence hypertension and post-operative complication were found to be similar among 3 groups. Conclusion: It is concluded that although all 3 inhalational agents can be used in patients undergoing supratentorial surgeries, desflurane has added advantage of faster post-operative recovery and emergence characteristics.

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