In supratentorial craniotomies the effect of dexmedetomidine additional to propofol and isoflurane anaesthesia

Many different anesthetic techniques have been used succesfully in supratentorial craniotomy surgeries. During neurosurgery we should maintaince the hemodynamic stability and prevent the brain edema. In postoperative term, to the determine the neurological complications earlier, patients recovery should be faster and comfortable. Dexmedetomidine is an agent that contributes hemodynamic stability. In our study we have chosen propofol because of it?s potential of decreasing cerebral blood flow, brain metabolic rate, making faster recovery and possible neuroprotective affects.In our study ASA I-II 30 patients electively undergoing supratentorial tumor surgery have randomly divided into two groups. In one of groups we used isoflurane and dexmedetomidine infusion, ın other group we used propofol and dexmedetomidine infusion. We administered bolus dose of dexmedetomidine to all patients 1?g/kg/10 minutes before induction. Further we administered 0.2-0.7 ?g/kg/h dexmedetomidine infusion. Anaesthesia was induced with propofol 2-2.5 mg/kg, vecuronium bromide 0.1 mg/kg and fentanyl cytrate 2?g/kg iv. followed by a propofol infüsion at 50-200 mg/kg/h in propofol group and % 0.5-0.9 isoflurane in isoflurane group. All for patients preoperatively, perioperatively and postoperatively first 2 hours hemodynamic datas and recovery parameters were recorded.No significant differences were found on hemodynamic parameters between two groups. However in propofol group there were significantly low brain relaxation scores, aldrete recovery scores (8.20±3.7/13.9±5.3) and other recovery parameters were significantly shorter. Also in propofol group, fentanyl consumption was significantly lower (265±68/365±158).Our study recommends that using propofol and dexmedetomidine together does not change the hemodynamic stability allows better surgery field and makes better recovery.