This study was conducted in two parts: 1. This first part was designed to determine thiopentone dose requirement for induction of anaesthesia with and without the use of Bispectral Index monitoring - Participant and Care Provider in appropriate study arm blinded. 2. As a secondary outcome, Bispectral index monitoring was used to observe changes in neuronal function in intraoperative period as well as haemodynamic changes intraoperatively - Participant and Care Provider blinded.
Surgery for traumatic brain injury is an anaesthetic challenge fraught with complications such as brain bulge, excessive bleeding, hypotension etc. As yet there are no anaesthetic regimen guidelines to follow for induction of anaesthesia in neurotrauma surgeries. Although the functional effect of anaesthetic agents on neuronal tissue is known quite well, there is lack of studies documenting the effect of these anaesthetic agents on head injured patients. It is also not known whether the requirement of anaesthetic agent in the same as a non head injured patient. This study was designed to assess the requirement of anaesthetic thiopentone in head injured patients and compare the anaesthetic usage with and without Bispectral index (BIS) monitoring. We also observed the real time change in neuronal function using Bispectral Index monitoring after craniotomy, i.e. effectively decompression and release of intracranial pressure intraoperatively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Thiopentone was administered in 50 mg boluses during induction of anaesthesia, until reduction of Bispectral Index value to less than 50, and total dose of thiopentone recorded.
Thiopentone requirement
Difference of thiopentone requirement with and without use of Bispectral Index guidance during induction of anaesthesia in traumatic brain injury patients.
Time frame: Beginning of anaesthetic induction till End of anaesthetic induction
Intraoperative Bispectral Index changes
Observation of Bispectral Index changes during craniotomy and decompression.
Time frame: Beginning of anaesthetic Induction till patient is shifted to post-anaesthesia care unit.
Intraoperative Systolic blood pressure changes
Observation of Systolic blood pressure changes during craniotomy and decompression.
Time frame: Beginning of anaesthetic Induction till patient is shifted to post-anaesthesia care unit.
Intraoperative Mean blood pressure changes
Observation of Mean blood pressure changes during craniotomy and decompression.
Time frame: Beginning of anaesthetic Induction till patient is shifted to post-anaesthesia care unit.
Intraoperative heart rate changes
Observation of heart rate changes during craniotomy and decompression.
Time frame: Beginning of anaesthetic Induction till patient is shifted to post-anaesthesia care unit.
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