Target-controlled Infusion Propofol Versus Sevoflurane Anaesthesia for Emergency Traumatic Brain Surgery: Comparison of the Outcomes
- Author:
Wan Mohd Nazaruddin Wan Hassan
;
Yusnizah Mohd Nasir
;
Rhendra Hardy Mohamad Zaini
;
Wan Fadzlina Wan Muhd Shukeri
- Publication Type:Original Article
- Keywords:
traumatic brain injury;
infusion;
propofol;
Glasgow Outcome Scale
- From:Malaysian Journal of Medical Sciences
2017;24(5):73-82
- CountryMalaysia
- Language:English
-
Abstract:
Background: The choice of anaesthetic techniques is important for the outcome of
traumatic brain injury (TBI) emergency surgery. The objective of this study was to compare
patient outcomes for target-controlled infusion (TCI) of propofol and sevoflurane anaesthesia.
Methods: A total of 110 severe TBI patients, aged 18–60, who underwent emergency
brain surgery were randomised into Group T (TCI) (n = 55) and Group S (sevoflurane) (n = 55).
Anaesthesia was maintained in Group T with propofol target plasma concentration of 3–6 μg/mL
and in Group S with minimum alveolar concentration (MAC) of sevoflurane 1.0–1.5. Both groups
received TCI remifentanil 2–8 ng/mL for analgesia. After the surgery, patients were managed in
the intensive care unit and were followed up until discharge for the outcome parameters.
Results: Demographic characteristics were comparable in both groups. Differences
in Glasgow Outcome Scale (GOS) score at discharge were not significant between Group T and
Group S (P = 0.25): the percentages of mortality (GOS 1) [27.3% versus 16.4%], vegetative and
severe disability (GOS 2–3) [29.1% versus 41.8%] and good outcome (GOS 4–5) [43.6% versus
41.8%] were comparable in both groups. There were no significant differences in other outcome
parameters.
Conclusion: TCI propofol and sevoflurane anaesthesia were comparable in the outcomes
of TBI patients after emergency surgery.
