Abstract
Background: The aim of the present study is to compare the recovery profiles, perioperative hemodynamic changes and undesirable side-effects such as postoperative nausea and vomiting (PONV) and shivering of patients undergoing anaesthesia with fentanyl-propofol or dexmedetomidine–propofol in supratentorial brain tumour surgery. Materials and Methods: In a prospective randomized double-blind study 70 ASA I-II patients aged 18-65 yrs of either sex, scheduled for supratentorial craniotomy with a maximum anticipated duration of 300 minutes, was allocated into two equal groups. One group received dexmedetomidine-propofol and other group received fentanyl-propofol as induction and maintenance of anaesthesia along with other drugs. Both the groups (n=35) received either i.v. dexmedetomidine or i.v. fentanyl 1 μg/kg 15mins prior to induction as loading dose followed by 0.5 μg/kg/ hr by continuous i.v. infusion peroperatively. At the end of surgery, recovery characteristics were assessed and recorded. Results: Patients in Group 1 recovered early compared to Group 2 in terms of response to verbal command (6.99±0.77 vs 8.79±0.88), extubation time (9.14±0.91 vs 10.83±1.06) and orientation time (11.14±0.703 vs12.76±1.10) which were found to be statistically significant. Induction dose of propofol and infusion dose of atracurium were significantly less in dexmedetomidine group in comparison to fentanyl group. Though in both the groups adverse effects were seen, but it was very less (less than 9%). Conclusion: Propofol-fentanyl and propofol-dexmedetomidine are both suitable for elective supratentorial craniotomy and provide similar intraoperative hemodynamic responses. Propofol-dexmedetomidine allows earlier cognitive recovery.
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