The Effects of Sevoflurane-Dexmedetomidine, Isoflurane-Dexmedetomidine and Desflurane-Dexmedetomidine Administrations on Hemodinamic Stability and Early Recovery in Patients Supratentorial Tumor Surgery

The Effects of Sevoflurane-Dexmedetomidine, Isoflurane-Dexmedetomidine and Desflurane-Dexmedetomidine Administrations on Hemodinamic Stability and Early Recovery in Patients Supratentorial Tumor SurgeryPurpose: Supplying hemodynamic stability and postoperative early recovery in neurosurgical operations is very important. In this study, we aimed to search effects of three different inhalation agents, which combined with dexmedetomidine infusion on hemodynamic stability and recovery in patients undergoing supratentorial tumor surgery.Material and methots: After approval of Faculty Ethical Commitee and patient consent, 90 patients undergoing intracranial supratentorial tumor surgery were included the study. Patients randomly divided into three groups. Sevoflurane 0.7-3% concentration in group I, desflurane 2-6% concentration in group II and isoflurane 0.5-1.5% concentration in group III patients were administered. All the patients, in three groups, received dexmedetomidine 0.5 microgr/kg dose during 10 minutes in preoperatively and continued 0.9 microgr/kg/h dose during operation. Sistolic, diastolic, mean arterial blood pressure and heart rate, inhalation agent concentration values were recorded in preoperative, after induction 1., 3. and 5. minutes, after entubation, before incision, after incision 1.and 3. minutes, dural incision, dural closing and extubation. Brain relaxation scores were evaluated (5 point scala) by the surgical team. Tramadol 2 mg/kg i.v and diclofenac 75 mg i.m were given to all patients for postoperative analgesia. Dexmedetomidine infusion was stopped before 30 minutes to the end of the operation and inhalation agents were stopped after end of the operation. Extubation, opening eye, response of verbal comments and orientation times and postoperative analgesia levels were recorded at 1, 4, 8, 12, 16, 20, 24th hours.Results: There were no statistically significantly differences in demographic data, operation times, hemodinamics parameters, needs of blood transfusion, brain relaxation scores and requirement of rescue analgesic among the three groups. The times of opening eye, response of verbal comments and orientation were found significantly the shortest in group II. We determined that the sevoflurane, deasflurane and isoflurane concentrations reduced during the operation.Conclusion: In conclusion, we determined that dexmedetomidine infusion is not sufficient to suppressing hemodynamic response, decreasing the using inhalation agent requirement and supplied the sufficiency brain relaxation. Side effects were similar among the groups however the recovery time was shorter in group desflurane-dexmedetomidine than the other groups.Key words: Dexmedetomidine, desflurane, isoflurane, sevoflurane, supratentorial tumor surgery