Remifentanil Infusion Alone During the Closure Period for Early Emergence Following Craniotomy

Yeditepe University Hospital80 enrolled

Overview

Total intravenous anaesthesia using propofol and remifentanil are routinely used drugs for this purpose. The hemodynamic stability and at the same time early emergency are the main goals following neurosurgery. However there is no standard for discontinuation time for manually controlled systems today. The investigators aimed to study the effect of remifentanil infusion alone for early emergence and hemodynamic stability during the closure period in patients undergoing supratentorial craniotomy.

Adult, American society of Anaesthesiologist score I-II, 80 patients who underwent elective supratentorial craniotomy for tumour resection were randomly assigned to group I or II. In group I; propofol was discontinued during the dural closure. After the propofol was discontinued, remifentanil dose was increased with the guidance of bispectral index spectrum and hemodynamic parameters. In group II; propofol discontinued before the end of the surgery. Time to awakening and extubation time, adverse events, total remifentanil and propofol consumptions and side effects were recorded. Heart rate and blood pressure were recorded during this period.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Supratentorial Neoplasms

Interventions

RemifentanilDRUG

0.1-0.5 mcg/kg/min infusion

PropofolDRUG

75-200 mcg/kg/min infusion

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anaesthesiologist physical status I-II * Glasgow Coma Scale score of 15 points * Elective supratentorial craniotomy for tumor resection * Supine position Exclusion Criteria: * Obese patient * Brain tumor greater than 30 mm in diameter * Postoperative cranial drainage * Hypertension * Diabetes mellitus * Reoperation * Pregnant * Breast feeding * Allergy to the study medications * History of cranial radiotherapy * Frontal bone flap * Intraoperative neuromonitoring

Locations (1)

Yeditepe University Hospital

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

Time of extubation

After the surgery, starting from three-pin head holder removal, an investigator asked each patient to open his or her eyes, squeeze the investigator's hand. When the patient opened his or her eyes, obeyed commands, resumed adequate respiration, hemodynamically stable and bispectral index spectrum \> 70-80 was extubated, and the time will be recorded. The patients will be followed for an expected average of 3 hours.

Time frame: 3 hours

Secondary Outcomes

Heart Rate

Heart rate per minute was recorded

Time frame: 6 hours

Mean arterial pressure were recorded

Mean arterial pressure (mmHg) was recorded

Time frame: 6 hours

Post-anesthesia awaking time

Post-anesthesia awaking time assessed as the interval (min:sec)required to

Time frame: 3 hours

Data from ClinicalTrials.gov

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