COMPARISON OF PROPOFOL INFUSION AND ISOFLURANE NITROGLYCERINE COMBINATION FOR CONTROLLED HYPOTENSION IN NEUROSURGICAL ANESTHESIA
Main Article Content
Keywords
Controlled Hypotension, Propofol Infusion, Isoflurane, Nitroglycerine, Neurosurgical Anesthesia, Hemodynamic Stability, Adverse Effects, Randomized Controlled Trial, Surgical Anesthesia, Patient Outcomes
Abstract
Objectives
The purpose of this study is to compare the effectiveness and safety of Propofol infusion versus an Isoflurane/Nitroglycerine combination for achieving controlled Hypotension during neurosurgical anesthesia.
Materials and Methods
This randomized controlled trial was undertaken in the Orthopaedic department of a tertiary care teaching hospital for eligible patients of High-energy tibial plateau fractures from January 2023 to June 2023. Patients from 18 to 65 years with essential hypertension requiring controlled Hypotension for surgery were enrolled, and patients with known hypersensitivity to the study drugs and significant cardiovascular/respiratory diseases were excluded.
Results
One hundred and twenty patients were recruited for the study. In terms of the onset of hypotensive effect, Propofol had a shorter mean time (8.2 ± 2.1 min) and lower incidence of Hypotension (30% compared to 50%, p < 0.05).
Conclusion
Propofol infusion is a better means of achieving controlled Hypotension in neurosurgical anesthesia, optimizing patient benefits, and enhancing patient outcomes.
References
2. MOHAMED, A.H., MOHAMED, G. and EL FIKI, M.D., 2021. Propofol Infusion versus Combination of Isoflurane with Nitroglycerine for Controlled Hypotensive Anesthesia in SpineSurgery: A Randomized Controlled Study. The Medical Journal of Cairo University, 89(March), pp.423-429.
3. RAjmohAn, Tumulu RAo, SwAin KumAR Sunil, KAuSeR DilShAD, Tumulu KumAR PRAnAy, GARG TANISHA, and MOHAMMED MOHIUDDIN AMER. "Comparison between Sevoflurane and Isoflurane for Controlled Hypotensive Anaesthesia in Patients undergoing Craniotomy for Supratentorial Intracranial Surgery: A Randomised Single-blinded Study." Journal of Clinical & Diagnostic Research 16, no. 7 (2022).
4. Gupta, K.K., Kumari, V., Kaur, S. and Singh, A., 2022. Comparative evaluation of Propofol versus dexmedetomidine infusion for hypotensive anesthesia during functional endoscopic sinus surgery: a prospective randomized trial. Anesthesia and Pain Medicine, 17(3), pp.271-279.
5. Khalifa, M.K., Ammar, R.A. and Elshafie, A.M., 2023. Comparison between intravenous dexmedetomidine and nitroglycerin infusions for induced Hypotension in patients undergoing vertebral fixation surgeries. Research and Opinion in Anesthesia & Intensive Care, 10(1), pp.54-61.
6. HAZNEDAR, B. and GÜRSOY, G.T., 2023. INVESTIGATION OF SMOKING IN CONTROLLED HYPOTENSION APPLIED WITH NITROGLYCERIN IN AUTOLARINGOLOGICAL SURGICAL PROCEDURES. Acta Medica, 39, p.1131.
7. Ma, X., Wang, Y., Lv, S., Li, Q., Xian, H. and Jiang, Z., 2020. Effects of dexmedetomidine combined with sevoflurane for controlled Hypotension on the renal function in craniocerebral operation. International Journal of Clinical and Experimental Medicine, 13(7), pp.5312-5318.
8. Modir, H., Moshiri, E., Shakeri, A. and Khalatbari, M., 2023. Comparison of the effects of tranexamic acid, nitroglycerin, and remifentanil on the prevention of bleeding during herniated lumbar intervertebral disc surgery: A randomized clinical trial. International Journal of Critical Illness and Injury Science, 13(1), pp.18-25.
9. Sinoglu, B. and Ersoy, A., 2023. Effects of Smoking on Controlled Hypotension with Nitroglycerin during Ear‑Nose‑Throat Surgery. Nigerian Journal of Clinical Practice, 26(6), pp.657-665.
10. Hossain, M.M., ul Alam, M., Akter, S. and Hussain, M.P.A., 2021. Comparison of Haemodynamic Stability of Etomidate versus Propofol for Induction of Anaesthesia in Patients undergoing Coronary Artery Bypass Graft Surgery. Journal of the Bangladesh Society of Anaesthesiologists, 34(1), pp.43-49.
11. Riedel, K., Thudium, M., Boström, A., Schramm, J. and Soehle, M., 2021. Controlled arterial Hypotension during resection of cerebral arteriovenous malformations. BMC neurology, 21, pp.1-11.
12. Shahinfar, J., Zeraati, H., Esmaili, A., Dartoomi, M. and Raoufian, H., 2022. Comparison of the Effect of Anesthesia with Isoflurane and TIVA on Liver Enzymes and Coagulation Tests in Patients Undergoing Cholecystectomy. Caspian Journal of Pediatrics, 24(1).
13. Murugesan, N., Kamalnath, A., Ranjan, R.V., Segaran, S. and Ranjan, R.V., 2024. Comparison of the Magnesium Sulphate With Paracetamol Combination vs the Fentanyl With Lignocaine Combination in Attenuating the Hemodynamic Response During Laryngoscopy and Intubation: A Prospective, Double-Blinded Randomized Controlled Study. Cureus, 16(8).
14. Xie, L., Wei, X., He, K., Wang, S. and Xu, M., 2024. Effects of different anesthetic regimens on postoperative cognitive function of elderly patients undergoing thoracic surgery: a double-blinded randomized controlled trial. Journal of Cardiothoracic Surgery, 19(1), p.394.
15. Lončar-Stojiljković, D.B., 2021. Effects of esmolol infusion on cardiovascular parameters and quality of general anaesthesia in younger and older patients. Scripta Medica, 52(2), pp.109-114.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Azam
Assistant Professor, Neurosurgery Department, Saidu Teaching Hospital Swat, Pakistan
Hameedullah
Senior Registrar of Neurosurgery, Muhammad Teaching Hospital Peshawar, Pakistan
Hashem Elessawy
New York Institute of Technology College of Osteopathic Medicine, New York, USA
Suraj Jain
New York Institute of Technology College of Osteopathic Medicine, New York, USA
Ghulam Mustafa
Associate Professor, Neurosurgery Department, Bolan Medical College Quetta, Pakistan
Amtul Hafeez
Associate Professor of Pharmacology, Gujranwala Medical College Gujranwala, Pakistan