Comparative Evaluation of Dexmedetomidine and Propofol Along With Scalp Block on Haemodynamic and Postoperative Recovery for Chronic Subdural Haematoma Evacuation Under Monitored Anaesthesia Care
OBJECTIVE: Chronic subdural haematoma (CSDH) is a common neurosurgical problem, and treatment includes evacuation of the haematoma by burr hole drainage. Commonly, these procedures are performed under local anaesthesia, general anaesthesia or, recently, with monitored anaesthesia care (MAC). We compared dexmedetomidine- and propofol-based sedation along with scalp nerve block for burr hole evacuation of CSDH.
METHODS: In this prospective randomised study, 62 patients were divided into the following two groups of 31 patients each: Group D and Group P. Group D received dexmedetomidine 1 μg kg-1 over 10 minutes as a loading dose, followed by 0.2-0.7 μg kg-1 hr-1. Group P received propofol 1 mg kg-1 over 10 minutes as a loading dose, followed by 1-3 mg kg-1 hr-1. The heart rate (HR) and blood pressure were measured at different intervals. The recovery parameter and satisfaction score were also recorded.
RESULTS: There were no significant differences noted in the demographic profile. A significant decrease in HR compared to preoperative value was seen in Group D compared to Group P. Blood pressure values were statistically significantly lower in both study groups, compared to preoperative values during the whole procedure and after surgery (p<0.05). Time to achieve modified Aldrete score of 9-10 was not significantly different between the groups (p=0.354). Surgeon satisfaction was significantly better in Group D compared to Group P (p<0.05), but patient satisfaction was similar between the groups (p=0.364).
CONCLUSION: Dexmedetomidine-based sedation compared to propofol, along with scalp block for MAC in patients undergoing burr hole evacuation of CSDH is associated with haemodynamic stability and greater surgeon satisfaction.
Errataetall: |
CommentIn: Turk J Anaesthesiol Reanim. 2019 Feb;47(1):79-80. - PMID 31276117 |
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Medienart: |
E-Artikel |
Erscheinungsjahr: |
2018 |
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Erschienen: |
2018 |
Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
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Enthalten in: |
Turkish journal of anaesthesiology and reanimation - 46(2018), 1 vom: 31. Feb., Seite 51-56 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Srivastava, Vinit Kumar [VerfasserIn] |
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Links: |
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Themen: |
Chronic subdural haematoma |
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Anmerkungen: |
Date Revised 21.03.2022 published: Print-Electronic CommentIn: Turk J Anaesthesiol Reanim. 2019 Feb;47(1):79-80. - PMID 31276117 Citation Status PubMed-not-MEDLINE |
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doi: |
10.5152/TJAR.2018.16878 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM287787168 |
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500 | |a Citation Status PubMed-not-MEDLINE | ||
520 | |a OBJECTIVE: Chronic subdural haematoma (CSDH) is a common neurosurgical problem, and treatment includes evacuation of the haematoma by burr hole drainage. Commonly, these procedures are performed under local anaesthesia, general anaesthesia or, recently, with monitored anaesthesia care (MAC). We compared dexmedetomidine- and propofol-based sedation along with scalp nerve block for burr hole evacuation of CSDH | ||
520 | |a METHODS: In this prospective randomised study, 62 patients were divided into the following two groups of 31 patients each: Group D and Group P. Group D received dexmedetomidine 1 μg kg-1 over 10 minutes as a loading dose, followed by 0.2-0.7 μg kg-1 hr-1. Group P received propofol 1 mg kg-1 over 10 minutes as a loading dose, followed by 1-3 mg kg-1 hr-1. The heart rate (HR) and blood pressure were measured at different intervals. The recovery parameter and satisfaction score were also recorded | ||
520 | |a RESULTS: There were no significant differences noted in the demographic profile. A significant decrease in HR compared to preoperative value was seen in Group D compared to Group P. Blood pressure values were statistically significantly lower in both study groups, compared to preoperative values during the whole procedure and after surgery (p<0.05). Time to achieve modified Aldrete score of 9-10 was not significantly different between the groups (p=0.354). Surgeon satisfaction was significantly better in Group D compared to Group P (p<0.05), but patient satisfaction was similar between the groups (p=0.364) | ||
520 | |a CONCLUSION: Dexmedetomidine-based sedation compared to propofol, along with scalp block for MAC in patients undergoing burr hole evacuation of CSDH is associated with haemodynamic stability and greater surgeon satisfaction | ||
650 | 4 | |a Journal Article | |
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650 | 4 | |a chronic subdural haematoma | |
650 | 4 | |a monitored anaesthesia care | |
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700 | 1 | |a Sharma, Sunil |e verfasserin |4 aut | |
700 | 1 | |a Kumar, Raj |e verfasserin |4 aut | |
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