Induction and Recovery Characteristics of Propofol during Emergency Neurosurgeries - Abstract
Total intravenous anesthesia is a technique involving infusion and maintenance of anesthetic state with intravenous drugs alone. Propofol has three important characteristics of ideal TIVA agent, i.e. rapid induction, rapid metabolism and rapid recovery. In view of these advantages we studied the characteristics of propofol in total intravenous anesthesia for craniotomy.
Aim: To study induction and recovery characteristics of propofol during craniotomy
Methods: A total of 60 patients aged 18-60 years belonging to ASA I and II physical status with GCS more than 13 were included in the study. Exclusion criteria was GCS less than 13, ASA more than II, hemodynamic instability and other associated injuries. All patients were induced with propofol (2mg/kg) and maintained with 50 ?g/kg/min infusion of propofol. Anesthesia was supplemented with fentanyl 2 mcg/kg and intubation facilitated with vecuronium 0.1 mg/kg. Based on hemodynamic signs, dose of propofol was adjusted in intraoperative period. Muscle relaxation was maintained with vecuronium 0.001mg/kg/ min and analgesia with fentanyl 1 mcg/kg/hour intraoperatively. During skin closure, infusions were discontinued and neuromuscular blockade reversed at the end of surgery.
Result: Propofol enabled smooth and rapid induction in all patients with mean induction time of 17.32 ± 2.43 seconds. During maintenance, propofol provided adequate depth of anesthesia in 53 (88.33%) of the patients, as assessed by hemodynamic changes. Recovery was good with short response time of 11.78 ± 2.99 minutes and orientation time of 21.86 ± 6.68 minutes.
Interpretation and conclusion: Propofol based total intravenous anesthesia provides rapid induction and smooth recovery in most of the head injury patients.