A Comparison of Emergence Characteristics, Intraoperative Haemodynamics and Intraoperative Brain Relaxation between Isoflurane and Desflurane in Patients Undergoing Craniotomy for Supratentorial Lesions.

Abstract

Background: Desflurane had increased anaesthetic armamentarium for maintenance of general anesthesia in neurosurgical cases. Few studies have compared isoflurane and desflurane for patients undergoing elective supratentorial craniotomy. Aims: The aim of this study is to compare emergence characteristics, intraoperative haemodynamic and intraoperative brain relaxation between isoflurane and desflurane in patients undergoing craniotomy for supratentorial lesions. Settings and Design: Prospective randomized and comparative study. Subjects and Methods: In this study, patients were randomly allocated in two groups. Groups I and D received Isoflurane and desflurane in MAC (0.8-1.2) during maintenance of general anesthesia after endotracheal intubation till skin closure. Emergence time, Extubation time, perioperative hypertension and intraoperative brain relaxation was compared between 2 groups across different time period. Statistical Analysis: Mean and standard deviation were calculated. Test of analysis between two groups was done by t-test and then P value was calculated. Results: Significantly lesser emergence time and extubation time in group D compared to group I (7.53±2.11 vs 15.10±1.7 and 10.87±1.961 vs 18.20±1.92). Perioperative haemodynamics were among comparable between both groups. Intraoperative brain relaxation was also comparable between 2 groups with more patients in desflurane group having grade 1 relaxation. Incidence of emergence hypertension and post-operative complication were also similar with 2 groups. Conclusion: It is concluded from the study that both inhalational agents isoflurane and desflurane can be used in patients undergoing supratentorial surgeries, desflurane has added advantage of faster post-operative recovery and intraoperative brain relaxation and emergence characteristics.

The comparative effects of desflurane and isoflurane on intraoperative cerebral hemodynamics, cardiovascular changes, and post-operative recovery in patients undergoing craniotomy for supratentorial tumors

“…13,[23][24][25][26] A study conducted by Chahar et al,27 found that both desflurane and isoflurane can be used in patients undergoing supratentorial craniotomy with desflurane having added advantage of faster post-operative recovery and emergence characteristics. Although both desflurane and isoflurane had comparable brain relaxation grades, 23 patients in desflurane group had Grade 1 brain swelling in comparison to 18 patients in isoflurane group (P=0.35).…”