Optional brain relaxation improves the surgeon's operating conditions and is likely to minimize the degree of retraction injury ,with the potential for providing patients with a better outcome. The choice of anesthetic drugs can affect intraoperative brain relaxation. Propofol suppresses brain metabolism, reduces cerebral blood flow, and provides satisfactory brain relaxation. Desflurane is often criticized in neurosurgery due to its cerebral vasodilation and potential to increase intracranial pressure, however, it has been found to have a little clinical significance. This study intends to compare the effects of desflurane with propofol on brain relaxation in patients with supratentorial tumors under mild hyperventilation, and to provide new clinical evidence for the use of desflurane in neurosurgical anesthesia.
To compare the effect of desflurane versus propofol combined with remifentanil anesthesia on brain relaxation in patients undergoing supratentorial tumor surgery with mild hyperventilation, and compare the emergence time and common complications during recovery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
111
After induction, anesthesia will be maintained with 0.8-1.3 MAC desflurane and 0.05-0.2 μg/kg/min remifentanil.
After induction, anesthesia will be maintained with 6-8 mg/kg/h propofol and 0.05- 0.2 μg/kg/min remifentanil
Beijing Tiantan Hospital, Capital Medical University
Beijing, Beijing Municipality, China
Proportion of satisfactory brain relaxation
Assessed by the neurosurgeon using a 4-point scale (1= perfectly relaxed, 2= satisfactorily relaxed, 3= firm brain, 4=bulging brain) at the opening of the dura mater, score 1 and 2 represent satisfactory brain relaxation
Time frame: during surgery
Emergence time
from drug discontinuation to eye opening
Time frame: from drug discontinuation to eye opening, assessed up to 1 hours
Extubation time
from drug discontinuation to tracheal extubation
Time frame: from drug discontinuation to tracheal extubation, assessed up to 1 hours
Postoperative complications
incidence of hypoxemia, hypotension, hypertension, tachycardia, bradycardia, agitation, shivering.
Time frame: from drug discontinuation to discharge from PACU (Postanesthesia care unit), assessed up to 3 hours
Postoperative pain and postoperative nausea and vomiting (PONV)
evaluated by Visual Analogue Score(VAS).
Time frame: during the PACU stay and postoperative day 1.
Duration in PACU (Postanesthesia care unit)
time from entering PACU to exiting PACU
Time frame: from entering PACU to exiting PACU, an expected average of 1 hour
Early postanesthesia cognitive recovery
evaluated by Short Orientation Memory Concentration Test (SOMCT)
Time frame: at 15, 30min after tracheal extubation
Dural tension
evaluated using a 4-point scale after bone flap removal.
Time frame: during surgery
Quality of anesthesia recovery
assessed by quality of recovery-15 scale (QoR-15)
Time frame: at postoperative day 1
Anesthesia expenses
Total cost of anesthesia
Time frame: at postoperative day 1
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