Use of Dexmedetomidine as an Adjuvant to Propofol along with Neurophysiological Monitoring of the Seventh Cranial Nerve during Cerebello- Pontine Tumour Excision Surgery

Abstract

Cerebello‑Pontine Angle (CPA) surgeries are very challenging for neurosurgeons as it lies very close to brain stem so various cranial nerves are at risk of damage. Generally, such surgeries require neuromuscular monitoring of various cranial nerves. For that we have to discontinue neuromuscular blocking agents and inhalational agents. Total Intravenous Anaesthesia (TIVA) avoids the use of neuromuscular blocking agents as well as inhalational agents. However, prolonged infusion of propofol is associated with risks, such as hypotension, delayed awakening, and metabolic acidosis, known as “Propofol Infusion Syndrome”. Dexmedetomidine now‑a‑days is used very commonly as an adjuvant to propofol and it significantly reduces the anaesthetic requirement. Addition of dexmedetomidine provides haemodynamic stability during such neurosurgeries. Here, authors have described anaesthetic management of a 46‑year‑old female patient posted for CPA excision along with seventh cranial nerve monitoring using dexmedetomidine with propofol.