Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2014 July;80(7) > Minerva Anestesiologica 2014 July;80(7):761-8

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Estratti

MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036


eTOC

 

ORIGINAL ARTICLES  


Minerva Anestesiologica 2014 July;80(7):761-8

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Propofol versus thiopental by target controlled infusion in patients undergoing craniotomy

Rozec B. 1, 2, Floch H. 3, Berlivet P. 1, Michel P. 1, Blanloeil Y. 1

1 Service d’Anesthésie et de Réanimation Chirurgicale, Centre Hospitalo-Universitaire Hôpital Laënnec, Nantes, France;
2 L’institut du Thorax, Unité Inserm, Nantes, France;
3 Service de Réanimation Chirurgicale, Hôpital de La Cavale Blanche, Centre Hospitalo-Universitaire, Brest, France


FULL TEXT  


BACKGROUND: For decades thiopental has been considered as the hypnotic drug of choice for intracranial surgery. However, total intravenous anesthesia performed with thiopental is associated with delayed recovery, whereas early post-operative neurological evaluation is critical. For this reason, target controlled infusion (TCI) of propofol is increasingly used for maintenance of anesthesia. However, a thiopental TCI has never been assessed for this purpose. We tested the hypothesis that a thiopental TCI provides an acceptable way to achieve early recovery compared to a propofol TCI during supratentorial surgery.
METHODS: Eighty patients undergoing elective craniotomy for a supratentorial tumor were randomized to receive either a propofol TCI (group P) or a thiopental TCI (group T). Both groups received a sufentanil TCI and the bispectral index was monitored. The primary end-point was time to tracheal extubation. Secondary end-points were per- and post-operative hemodynamics as well as respiratory and recovery parameters. Assessment of study end-points was performed by an intensive care specialist blinded (like the patient) to the received hypnotic.
RESULTS: Time to extubation was significantly (P<0.0001) shorter in group P (median 149 minutes; interquartile range 72-250 minutes) than in group T (median 453 minutes; interquartile range 286-813 minutes). Similarly, the recovery parameters were significantly better in group P than in group T. There was no difference between groups in terms of patient characteristics and hemodynamic parameters.
CONCLUSION: Even with TCI and bispectral index monitoring, thiopental is associated with an inappropriate delayed recovery from supratentorial surgery compared to propofol TCI.

inizio pagina

Publication History

Per citare questo articolo

Corresponding author e-mail

yvonnick.blanloeil@chu-nantes.fr