Propofol sedation during awake craniotomy for seizures: patient-controlled administration versus neurolept analgesia

Anesthesia and Analgesia
I A HerrickJ Kirkby

Abstract

This prospective study evaluated the safety and efficacy of patient-controlled sedation (PCS) using propofol during awake seizure surgery performed under bupivacaine scalp blocks. Thirty-seven patients were randomized to receive either propofol PCS combined with a basal infusion of propofol (n = 20) or neurolept analgesia using an initial bolus dose of fentanyl and droperidol followed by a fentanyl infusion (n = 17). Both groups received supplemental fentanyl and dimenhydrinate for intraoperative pain and nausea, respectively. Comparisons were made between groups for sedation, memory, and cognitive function, patient satisfaction, and incidence of complications. Levels of intraoperative sedation and patient satisfaction were similar between groups. Memory and cognitive function were well preserved in both groups. The incidence of transient episodes of ventilatory rate depression (<8 bpm) was more frequent among the propofol patients (5 vs 0, P = 0.04), particularly after supplemental doses of opioid. Intraoperative seizures were more common among the neurolept patients (7 vs 0, P = 0.002). PCS using propofol represents an effective alternative to neurolept analgesia during awake seizure surgery performed in a monitored care envi...Continue Reading

References

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Citations

Mar 20, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·B BissonnetteV Un
May 12, 2006·Der Anaesthesist·U SchulzW Boemke
May 4, 2004·Annales Françaises D'anesthèsie Et De Rèanimation·V BonhommeP Hans
May 4, 2004·The British Journal of Oral & Maxillofacial Surgery·Zuhal Küçükyavuz, Mine Cambazoğlu
Feb 27, 2004·Journal of Clinical Anesthesia·Carin A HagbergJames M Berry
Jun 12, 1999·Annales Françaises D'anesthèsie Et De Rèanimation·F SztarkP Erny
Feb 15, 2001·Journal of Clinical Anesthesia·W K TongierB Mickey
Oct 1, 2007·Neuromodulation : Journal of the International Neuromodulation Society·Paul J FordAli R Rezai
Mar 28, 2012·Neurologia Medico-chirurgica·Takamasa Kayama, UNKNOWN Guidelines committee of the Japan awake surgery conference
Nov 26, 2014·Saudi Journal of Anaesthesia·Mahmood GhazanwyAshish Sinha
Jun 27, 2001·Journal of Neurosurgical Anesthesiology·H BerkenstadtZ Ram
Sep 4, 2010·Anesthesiology Research and Practice·Joseph SebeoIrene P Osborn
Apr 25, 2015·Journal of Neurosurgery·Shawn L Hervey-JumperMitchel S Berger
Mar 1, 2012·Journal of Neurosurgical Anesthesiology·Barbara SantiniMassimo Gerosa
Mar 22, 2002·Journal of Neurosurgical Anesthesiology·Teresa TijeroAlberto Puig
Oct 24, 2020·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·A Yu LubninG L Kobyakov

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