Comparison of dexmedetomidine versus propofol combined anesthesia for brain protection in patients undergoing intracranial tumor resection

Abstract

Objective To compare dexmedetomidine versus propofol combined anesthesia for brain protection in the patients undergoing intracranial tumor resection.Methods Forty patients of both sexes,aged 18-60 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective cerebral glioma or meningioma resection under general anesthesia,were randomly divided into 2 groups (n =20 each) using a random number table:dexmedetomidine combined anesthesia group (group D) and propofol combined anesthesia group (group P).Before induction of anesthesia,dexmedetomidine 1 μg/kg (4 μg/ml) was infused over 10 min in group D,while the equal volume of normal saline was infused over 10 min in group P.Anesthesia was induced with midazolam,fentanyl,cisatracurium and etomidate and maintained with remifentanil,isoflurane,cisatracurium and dexmedetomidine (0.2-1.0 μg·kg-1 ·h-1,group D) or propofol (3-10 mg·kg-1 ·h-1,group P).The patients were endotracheally intubated and mechanically ventilated.The doses of dexmedetomidine and propofol were adjusted to maintain BIS value at 40-50.Before induction of anesthesia (baseline),when the dura of brain was opened,at the end of tumor removal,at the end of operation,and at 24 h after operation (T0-4),venous blood samples were taken to determine the concentrations of serum neuron-specific enolase (NSE) and S100β.The emergence time and extubation time were recorded.Results Compared with the baseline value at T0,no significant changes were found in the concentrations of serum NSE and S100β at T1,and the concentrations of serum NSE and S100β were significantly increased at T2-4 in the two groups.Compared with group P,the concentrations of serum NSE and S100β were significantly decreased at T3,4,and the emergence time and extubation time were shortened in group D.Conclusion Dexmedetomidine combined anesthesia provides better efficacy than propofol combined anesthesia for brain protection in the patients undergoing intracranial tumor resection. Key words: Dexmedetomidine; Propofol; Anesthesia; Brain tumor; Brain injuries