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Optional brain relaxation improves the surgeon's operating conditions and is likely to minimize the degree of retraction injury ,with the potential for providing patients with a better outcome. The choice of anesthetic drugs can affect intraoperative brain relaxation. Propofol suppresses brain metabolism, reduces cerebral blood flow, and provides satisfactory brain relaxation. Desflurane is often criticized in neurosurgery due to its cerebral vasodilation and potential to increase intracranial pressure, however, it has been found to have a little clinical significance. This study intends to compare the effects of desflurane with propofol on brain relaxation in patients with supratentorial tumors under mild hyperventilation, and to provide new clinical evidence for the use of desflurane in neurosurgical anesthesia.
To compare the effect of desflurane versus propofol combined with remifentanil anesthesia on brain relaxation in patients undergoing supratentorial tumor surgery with mild hyperventilation, and compare the emergence time and common complications during recovery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Desflurane inhalational anesthesia | Experimental |
| |
| Propofol total intravenous anesthesia | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Desflurane | Drug | After induction, anesthesia will be maintained with 0.8-1.3 MAC desflurane and 0.05-0.2 μg/kg/min remifentanil. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of satisfactory brain relaxation | Assessed by the neurosurgeon using a 4-point scale (1= perfectly relaxed, 2= satisfactorily relaxed, 3= firm brain, 4=bulging brain) at the opening of the dura mater, score 1 and 2 represent satisfactory brain relaxation | during surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Emergence time | from drug discontinuation to eye opening | from drug discontinuation to eye opening, assessed up to 1 hours |
| Extubation time | from drug discontinuation to tracheal extubation |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Tiantan Hospital, Capital Medical University | Beijing | Beijing Municipality | 100070 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36624384 | Derived | Jiang Z, Wu Y, Liang F, Jian M, Liu H, Mei H, Han R. Brain relaxation using desflurane anesthesia and total intravenous anesthesia in patients undergoing craniotomy for supratentorial tumors: a randomized controlled study. BMC Anesthesiol. 2023 Jan 10;23(1):15. doi: 10.1186/s12871-023-01970-z. |
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| ID | Term |
|---|---|
| D015173 | Supratentorial Neoplasms |
| ID | Term |
|---|---|
| D001932 | Brain Neoplasms |
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D000077335 | Desflurane |
| D015742 | Propofol |
| ID | Term |
|---|---|
| D005019 | Ethyl Ethers |
| D004987 | Ethers |
| D009930 | Organic Chemicals |
| D008738 | Methyl Ethers |
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|
| Propofol | Drug | After induction, anesthesia will be maintained with 6-8 mg/kg/h propofol and 0.05- 0.2 μg/kg/min remifentanil |
|
|
| from drug discontinuation to tracheal extubation, assessed up to 1 hours |
| Postoperative complications | incidence of hypoxemia, hypotension, hypertension, tachycardia, bradycardia, agitation, shivering. | from drug discontinuation to discharge from PACU (Postanesthesia care unit), assessed up to 3 hours |
| Postoperative pain and postoperative nausea and vomiting (PONV) | evaluated by Visual Analogue Score(VAS). | during the PACU stay and postoperative day 1. |
| Duration in PACU (Postanesthesia care unit) | time from entering PACU to exiting PACU | from entering PACU to exiting PACU, an expected average of 1 hour |
| Early postanesthesia cognitive recovery | evaluated by Short Orientation Memory Concentration Test (SOMCT) | at 15, 30min after tracheal extubation |
| Dural tension | evaluated using a 4-point scale after bone flap removal. | during surgery |
| Quality of anesthesia recovery | assessed by quality of recovery-15 scale (QoR-15) | at postoperative day 1 |
| Anesthesia expenses | Total cost of anesthesia | at postoperative day 1 |
| D009369 | Neoplasms |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006845 |
| Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |